幽门螺杆菌感染对十二指肠溃疡患者血清胃泌素、一氧化氮合酶影响的研究

Changes of nitric oxide synthase and gastrin of Helicobacter pylori infection in duodenal ulcer

目的 :探讨幽门螺杆菌 (Helicobacterpylori,H .ylori)对十二指肠溃疡 (DU )患者血清胃泌素、胃粘膜一氧化氮合酶(NOS)的影响及其意义 ,从而为治疗H .pylori相关性疾病寻求新的措施。 方法 :本文观察了 5 9例H .pylori阳性活动期DU患者 ,采用三联疗法 (奥美啦唑 2 0mgbid ,克拉霉素 0 .2 5tid ,甲硝唑 0 .2tid ,疗程 2周 )根除H .pylori,在抗H .pylori治疗前后对胃粘膜NOS和空腹血清胃泌素进行检测 ,并与年龄相比拟的 39例非溃疡性消化不良患者进行比较。结果 :H .pylori阳性活动期DU患者胃粘膜NOS及空腹血清胃泌素浓度 ,在治疗前显著高于治疗后愈合期DU患者 (P <0 .0 0 1和P <0 .0 0 5 ) ,而愈合期DU患者的胃粘膜NOS和空腹胃泌素浓度与对照组相比 ,无显著性差异 (P >0 .0 5 ) ;空腹血清胃泌素浓度在H .pylori根除后明显下降。结论 :H .pylori感染可引起胃粘膜NOS生成增加、活性增强 ,由此调节着胃泌素的分泌 ,导致溃疡等胃肠疾病的发生 ;临床上可通过寻找特异性抑制NOS试剂 。

Objective:To investigate the important relations between Helicobacter pylori (H.pylori) infection and serum gastrin level and nitric oxide synthase (NOS) activity in order to look for a method treating diseases associated with H.pylori.Methods:Before and after triple therapy against H.pylori with omeprazole 20mg twice a day,clarithromycin 0.25,and metronidazole 0.2 3 times a day for two weeks,fifty-nine with active DU and H.pylori positive,and 39 cases with non-ulcer dyspepsia as control were determined for NOS activity of gastric mucosa and fast serum gastrin level.Results:Patients with DU activity and H. pylori infection,before treatment,had an increased in NOS activity of gastric mucosa and fast serum gastrin level than those after treatment and the control,there were great importance( P <0.001 and P <0.005 respectively);NOS activity and gastrin level between the patients with healed DU and the control were of no significant difference.The changes of NOS activity were not significant whether H.pylori eradicated or not,it maybe link with no-healed peptic ulcer and a few patients,but there was a significant decrease of gastrin level when H.pylori was eradicated.Conclusion:Our findings showed H.pylori infection could increase NOS to promote gastrin secretion,and lead to gastroenterological diseases such as peptic ulcer.It clearly implied to us:through taking some measures to inhibit NOS activity to treat diseases associated with H.pylori.