伏诺拉生联合内镜下止血治疗幽门螺旋杆菌相关十二指肠溃疡的效果及对炎性因子的影响

Effect of Vonoprazan combined with endoscopic hemostasis on Hp⁃associated duodenal ulcer and its effect on inflammatory factors

目的:分析伏诺拉生联合内镜下止血治疗幽门螺旋杆菌(Hp)相关十二指肠溃疡的效果及对炎性因子的影响。方法:选取2022年1月至2023年4月汕头市中心医院收治的108例Hp相关十二指肠溃疡患者作为研究对象,将患者根据不同的治疗方案分为试验组(n=60)与对照组(n=48)。两组均给予Hp根除治疗,对照组联合消化内镜下注射去甲肾上腺素溶液,试验组在对照组的基础上联合口服富马酸伏诺拉生片治疗。比较两组的治疗效果、胃泌素(GAS)、溃疡组织炎性因子[血清半胱氨酸蛋白酶-1(Caspase-1)、NOD样受体蛋白3(NLRP3)、白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)]、Hp根除率、Hp再感染率以及不良反应发生率。结果:试验组的治疗有效率优于对照组,差异具有统计学意义(P<0.05);两组治疗后的GAS水平均低于治疗前,且试验组低于对照组,差异均具有统计学意义(P<0.05);两组治疗后的Caspase-1、NLRP3、IL-18及IL-1β水平均低于治疗前,且试验组低于对照组,差异均具有统计学意义(P<0.05);试验组的Hp根除率优于对照组,差异有统计学意义(P<0.05);两组的Hp再感染率、不良反应发生率比较差异无统计学意义(P>0.05)。结论:伏诺拉生联合内镜下止血治疗Hp相关十二指肠溃疡具有良好效果,能够抑制胃酸分泌与调控炎性因子水平,加快患者恢复。

Objective:To analyze the effect of Vonoprazan fumarate combined with endoscopic hemostasis on helicobacter pylori(Hp)-associated duodenal ulcer and its effect on inflammatory factors.Methods:108 patients with Hp-associated duodenal ulcer admitted to Shantou Central Hospital from January 2022 to April 2023 were selected as the study objects.According to different treatment regimens,the patients were divided into experimental group(n=60)and control group(n=48).Both groups were given Hp eradication therapy,the control group was combined with digestive endoscope injection of norepinephrine solution,and the experimental group was combined with oral Vonoprazan fumarate tablet on the basis of the control group.The therapeutic effect,secretion of gastrin(GAS),ulcer tissue inflammatory factors[Caspase-1,NOd-like receptor protein 3(NLRP3),interleukin-18(IL-18),interleukin-1β(IL-1β)],Hp eradication rate,Hp reinfection rate and incidence of adverse reactions were compared between the two groups.Results:The effective rate of the experimental group was better than that of the control group,the difference was statistically significant(P<0.05).The levels of GAS levels in both groups after treatment were lower than before treatment,and the experimental group was lower than the control group,the differences were statistically significant(P<0.05).Serum Caspase-1,NLRP3,IL-18 and IL-1βlevels in 2 groups after treatment were lower than before treatment,and the experimental group was lower than the control group,the differences were statistically significant(P<0.05).Hp eradication rate of experimental group was better than control group,the difference was statistically significant(P<0.05).There was no significant difference in Hp reinfection rate and incidence of adverse reactions between the two groups(P>0.05).Conclusion:Vonoprazan combined with endoscopic hemostasis has good effect in the treatment of Hp-associated duodenal ulcer,which can inhibit the secretion of gastric acid and regulate the level of inflammatory factors,and accelerate the recovery of patients.