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目的:探讨不同菌型幽门螺杆菌(Helicobacter pylori,H.pylori)感染消化性溃疡(peptic ulcer,PU)患者血清白介素10(interleukin-10,IL-10)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)的表达.方法:随机选择经胃镜检查诊断为消化性溃疡的患者94例,进行内镜下胃黏膜活检快速尿素酶试验检测H.pylori感染状况,H.pylori阳性者进一步抽血进行分型检测,采用免疫印迹法检测血清H.pylori CagA、VacA、UreB、UreA等4项基因抗体;所有受检者均予抽血检测血清IL-10、TNF-α的含量.结果:H.pylori感染状况:94例消化性溃疡中H.pylori阳性病例84例,其中十二指肠球部溃疡56例,胃溃疡28例,H.pylori阴性病例10例;Ⅰ型H.pylori感染64例(十二指肠球部溃疡44例,胃溃疡20例);Ⅱ型H.pylori感染20例(十二指肠球部溃疡12例,胃溃疡8例).血清IL-10的表达状况:Ⅰ型H.pylori感染组检测值(31.51pg/mL±11.58 pg/mL)略高于Ⅱ型H.pylori感染组(22.02 pg/mL±13.50 pg/mL),统计学比较无明显差异(P>0.05),但明显高于H.pylori阴性组检测值(18.87 pg/mL±6.45 pg/mL),统计学比较有显著差异(P<0.05);Ⅱ型H.pylori感染组检测值与H.pylori阴性组比较无明显差异(P>0.05).Ⅰ型H.pylori感染及Ⅱ型H.pylori感染组中十二指肠球部溃疡组检测值(32.25pg/mL±19.33 pg/mL及18.57 pg/mL±8.46 pg/mL)与胃溃疡组检测值(29.86 pg/mL±14.80pg/mL及27.20 pg/mL±8.12 pg/mL)比较无明显差异.血清TNF-α的表达状况:Ⅰ型H.pylori感染组及Ⅱ型感染组的检测值(42.66 pg/mL±11.41 pg/mL及28.67 pg/mL±8.27 pg/mL)与H.pylori阴性组(11.24 pg/mL±4.31pg/mL)比较均明显增高(P<0.05);Ⅰ型H.pylori感染组与Ⅱ型感染组比较明显升高(P<0.05);Ⅰ型H.pylori感染组中十二指肠球部溃疡组检测值(47.13 pg/mL±10.20 pg/mL)明显高于胃溃疡组检测值(32.85 pg/mL±7.28 pg/mL)(P<0.05);Ⅱ型H.pylori感染组中十二指肠球部溃疡组检测值(28.83 pg/mL±11.38 pg/mL)与胃溃疡组检测值(28.42 pg/mL±3.79 pg/mL)比较无明显差异.结论:Ⅰ型H.pylori感染是消化性溃疡主要致病因素;血清IL-10的表达在Ⅰ型H.pylori感染明显增高,但在不同菌型H.pylori感染及不同部位的溃疡方面均无明显差异;血清TNF-α的表达在Ⅰ型及Ⅱ型H.pylori感染均明显增高,尤见于Ⅰ型H.pylori感染,且在Ⅰ型H.pylori感染十二指肠球部溃疡明显高于胃溃疡.
Objective: To investigate the relationship between interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in patients with peptic ulcer (PU) infection of Helicobacter pylori α, TNF-α) .Methods: Ninety-four patients diagnosed as peptic ulcer by gastroscopy were randomly selected to undergo H.pylori infection by endoscopic mucosal biopsy and H.pylori positive Further blood tests were performed to detect the genotypes. Western blotting was used to detect serum anti-Hp antibodies such as H.pylori CagA, VacA, UreB and UreA. All the subjects were tested for blood levels of IL-10 and TNF-α. Results: H.pylori infection was detected in 84 cases of H.pylori in 94 cases of peptic ulcer, including 56 cases of duodenal ulcer, 28 cases of gastric ulcer, 10 cases of H.pylori negative cases and 1 cases of type H. 64 cases of pylori infection (duodenal ulcer in 44 cases, gastric ulcer in 20 cases), type Ⅱ H.pylori infection in 20 cases (duodenal ulcer in 12 cases, gastric ulcer in 8 cases), serum IL-10 (31.51 pg / mL ± 11.58 pg / mL) was slightly higher than that of H.pylori infection group (22.02 pg / mL ± 1 3.50 pg / mL), there was no statistical difference (P> 0.05), but it was significantly higher than that of H.pylori negative group (18.87 pg / mL ± 6.45 pg / mL) 0.05). There was no significant difference between H.pylori infection group and H.pylori negative group (P> 0.05) .In the group of H.pylori infectionⅠ and H.pylori infectionⅡ, duodenal ulcer (32.25 pg / mL ± 19.33 pg / mL and 18.57 pg / mL ± 8.46 pg / mL) and the gastric ulcer group (29.86 pg / mL ± 14.80 pg / mL and 27.20 pg / mL ± 8.12 pg / mL, respectively) ), The level of TNF-α in serum was significantly higher than that in type Ⅰ H.pylori infection and type Ⅱ infection (42.66 pg / mL ± 11.41 pg / mL and 28.67 pg / mL ± 8.27 pg / mL) And H.pylori negative group (11.24 pg / mL ± 4.31 pg / mL) were significantly higher (P <0.05); type Ⅰ H.pylori infection group and type Ⅱ infection group was significantly higher (P <0.05); Ⅰ (47.13 pg / mL ± 10.20 pg / mL) in H.pylori infection group was significantly higher than that in gastric ulcer group (32.85 pg / mL ± 7.28 pg / mL) (P < 0.05). The detection value of duodenal ulcer in type Ⅱ H.pylori infection group (28.83 pg / mL ± 11.38 pg / mL) and gastric ulcer Group (28.42 pg / mL ± 3.79 pg / mL) had no significant difference.Conclusion: H.pylori infection of type Ⅰ is the main pathogenic factor of peptic ulcer, and the level of serum IL-10 is significantly higher in type I H.pylori infection But there was no significant difference in the infection of H.pylori and the ulcer in different sites. The expression of TNF-α in serum was significantly higher in type Ⅰ and type Ⅱ H.pylori infections, especially in type Ⅰ H.pylori infection , And in H.pylori infection duodenal ulcer was significantly higher than gastric ulcer.