Hp阳性消化性溃疡患者PBMCs中Wnt和β-Catenin mRNA表达水平及其与并发出血的关系

Expression of Wnt and β-Catenin mRNA in PBMCs of patients with Hp positive peptic ulcer and the relationship with hemorrhage

目的 探讨幽门螺杆菌(Hp)阳性消化性溃疡(PU)患者外周血单个核细胞(PBMCs)中Wnt、β-连环蛋白(β-Catenin)mRNA表达情况及与并发出血的关系。方法 选取2019年1月-2023年1月蒙城县第一人民医院Hp阳性PU患者80例为研究组,同期选取Hp阴性PU患者45例为对照组。比较两组PBMCs中Wnt、β-Catenin mRNA表达水平,logistic回归分析Hp阳性PU并发出血影响因素,并分析Hp分型Ⅰ型及Wnt、β-Catenin mRNA参与促出血形成的交互作用。结果 研究组PBMCs中Wnt mRNA(0.78±0.19)、β-Catenin mRNA(0.71±0.20)表达高于对照组[(0.49±0.16)、(0.50±0.14)],差异均有统计学意义(t=8.654、6.232,P均<0.001)。logistic回归模型显示,Hp分型Ⅰ型(OR=0.333,95%CI:0.191~0.582)及PBMCs中Wnt mRNA(OR=4.690,95%CI:2.961~7.429)、β-Catenin mRNA(OR=4.892,95%CI:3.154~7.587)高表达均为Hp阳性PU并发出血独立危险因素(P均<0.05)。Hp分型Ⅰ型、Wnt mRNA高表达时出血风险是Hp分型Ⅱ型、Wnt mRNA低表达时的58.125倍,是其他未知因子(OR=1)的36.312倍(RERI=36.312),协同效应为二者单独存在产生效应之和的2.745倍(SI=2.745),在二者共存的出血风险中有62.47%(AP=62.47%)是由两者协同作用引起的;Hp分型Ⅰ型、β-Catenin mRNA高表达时出血风险是Hp分型Ⅱ型、β-Catenin mRNA低表达时的51.200倍,是其他未知因子(OR=1)的30.933倍(RERI=30.933),协同效应为二者单独存在产生效应之和的2.748倍(SI=2.748),在二者共存的出血风险中有60.42%(AP=60.42%)是由两者协同作用引起的。结论 Hp阳性PU患者PBMCs中Wnt、β-Catenin mRNA异常高表达,与并发出血有关,且Hp分型Ⅰ型与Wnt、β-Catenin mRNA对Hp阳性PU出血形成存在正向交互作用。

Objective To investigate the mRNA expression of Wnt and β-Catenin in peripheral blood mononuclear cells(PBMCs)in patients with Helicobacter pylori(Hp)positive peptic ulcer(PU)and the relationship between the mRNA expression and the complication of hemorrhage.Methods Eighty patients with Hp-positive PU in the Mengcheng County First People's Hospital from January 2019 to January 2023 were selected as the study group,and 45 patients with HPnegative PU were selected as the control group during the same period.The expression of Wnt and β-Catenin mRNA in PBMCs of the two groups was compared,and the influencing factors of bleeding in HP-positive PU were analyzed by logistic regression.The interaction of Hp type Ⅰ and Wnt and β-Catenin mRNA in promoting bleeding formation was analyzed.Results The expression of Wnt mRNA(0.78±0.19)and β-Catenin mRNA(0.71±0.20)in PBMCs of the study group was higher than those of the control group[(0.49±0.16),(0.50±0.14)],and the differences were statistically significant(t=8.654,6.232;both P<0.001).Logistic regression model showed that Hp type Ⅰ(OR=0.333,95%CI:0.191-0.582)and PBMCs contained high levels of Wnt mRNA(OR=4.690,95%CI:2.961-7.429)and β-Catenin mRNA(OR=4.892,95%CI:3.154-7.587)were independent risk factors for hemorrhage in Hp-positive PU(all P<0.05).The bleeding risk was 58.125 times higher in Hp type Ⅰ and high expression level of Wnt mRNA than that in Hp type Ⅱ and low expression level of Wnt mRNA,and 36.312 times higher than that of other unknown factors(OR=1)(RERI=36.312);the synergistic effect was 2.745 times(SI=2.745)of the sum of the two effects,and 62.47%(AP=62.47%)of the co-existing bleeding risk was caused by the synergistic effect of both.The bleeding risk was 51.200 times higher in Hp type Ⅰ and high expression level ofβ-Catenin mRNA than that in Hp type Ⅱ and low expression level of β-Catenin mRNA,and 30.933 times higher than that in other unknown factors(OR=1)(RERI=30.933);the synergistic effect was 2.748 times(SI=2.748)of the sum of the two effects,and 60.42%(AP=60.42%) of the co-existing bleeding risk was caused by the synergistic effect of both.Conclusion The abnormal high expression levels of Wnt and β-Catenin mRNA in PBMCs of Hp-positive PU patients was related to the complication of bleeding,and there was a positive interaction between Wnt and β-Catenin mRNA of Hp type Ⅰ and the HP-positive PU bleeding.