胃泌素、转化生长因子-α、三叶因子1水平变化与幽门螺杆菌感染伴胃溃疡患者治疗反应性的关系

Relationships between changes in the levels of gastrin,transforming growth factor-αand trilobite factor 1 and therapeutic responsiveness in patients with gastric ulcer and Hp infection

目的探讨胃泌素(Gas)、转化生长因子-α(TGF-α)、三叶因子1(TFF1)水平变化与幽门螺杆菌(Hp)感染伴胃溃疡患者治疗反应性的关系。方法选取该院2020年7月至2022年6月收治的105例Hp感染伴胃溃疡患者为研究对象,根据入院时炎症活动度将患者分为轻度组(31例)、中度组(48例)和重度组(26例),根据抗Hp治疗2周后的治疗反应性,将患者分为有效组、无效组。比较轻度组、中度组和重度组入院时血清Gas、TGF-α、TFF1水平,分析入院时血清Gas、TGF-α、TFF1水平与炎症活动度相关性,比较有效组和无效组入院时、治疗2周后血清Gas、TGF-α、TFF1水平,采用偏回归分析Hp感染伴胃溃疡患者治疗无效的影响因素,采用受试者工作特征(ROC)曲线分析治疗2周后血清Gas、TGF-α、TFF1检测对治疗反应性的评估价值。结果入院时血清Gas、TGF-α、TFF1水平在重度组、中度组、轻度组中依次降低,各组两两比较,差异有统计学意义(P<0.05)。入院时血清Gas、TGF-α、TFF1水平与炎症活动度均呈正相关(r=0.741、0.684、0.518,P<0.05)。入院时有效组和无效组血清Gas、TGF-α、TFF1水平比较,差异无统计学意义(P>0.05);治疗2周后无效组血清Gas、TGF-α、TFF1水平均高于有效组,差异有统计学意义(P<0.05)。治疗2周后血清Gas>46.79 ng/L、TGF-α>8.53 mg/L、TFF1>3.40 ng/mL是Hp感染伴胃溃疡患者治疗无效的危险因素(P<0.05)。血清Gas、TGF-α、TFF1水平联合检测评估Hp感染伴胃溃疡患者治疗无效的曲线下面积最大,为0.921。结论Hp感染伴胃溃疡患者血清Gas、TGF-α、TFF1水平与治疗反应性有关,联合检测可为临床预测治疗反应性、改善预后提供参考。

Objective To investigate the relationships between the levels of gastrin(Gas),transforming growth factor-α(TGF-α),trilobal factor 1(TFF1)and the therapeutic responsiveness of patients with Helicobacter pylori(Hp)infection and gastric ulcer.Methods A total of 105 Hp-infected gastric ulcer patients admitted to Xuchang Hospital from July 2020 to June 2022 were selected as the study objects.According to the inflammatory activity at admission,the patients were divided into mild group(31 cases),moderate group(48 cases)and severe group(26 cases).According to the treatment reactivity after 2 weeks of anti-Hp treatment,the patients were divided into effective group and ineffective group.The serum Gas,TGF-αand TFF1 levels of the mild group,moderate group and severe group were compared at admission,and the correlations between the serum Gas,TGF-α,TFF1 levels and inflammatory activity were analyzed at admission.The serum Gas,TGF-αand TFF1 levels of the effective group and the ineffective group were compared at admission and 2 weeks after treatment.Partial regression analysis was used to analyze the influencing factors of treatment ineffectiveness in patients with gastric ulcer and Hp infection,and receiver operating characteristic(ROC)curve was used to analyze the evaluation value of serum Gas,TGF-αand TFF1 levels on treatment responsiveness after 2 weeks of treatment.Results The levels of serum Gas,TGF-αand TFF1 in severe group,moderate group and mild group decreased sequentially at admission,and pairwise comparison of each group showed statistically significant differences(P<0.05).Serum Gas,TGF-αand TFF1 levels correlated positively with inflammatory activity at admission(r=0.741,0.684,0.518,P<0.05).There was no significant difference on serum Gas,TGF-αand TFF1 levels between the effective group and the ineffective group at admission(P>0.05).After 2 weeks of treatment,the levels of Gas,TGF-α and TFF1 in the ineffective group were higher than those in the effective group,and the differences were statistically significant (P <0.05).Gas>46.79 ng/ L,TGF-α>8.53 mg/L and TFF1>3.40 ng/mL after 2 weeks of treatment were risk factors for ineffective treatment in patients with gastric ulcer and Hp infection.The area under the curve of serum Gas,TGF-α and TFF1 was the largest (0.921) in Hp-infected patients with gastric ulcer.Conclusion Serum Gas,TGF-α and TFF1 levels in Hp-infected patients with gastric ulcer relate to treatment reactivity,and combined detection can provide a reference for clinical prediction of treatment reactivity and improvement of prognosis.