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目的:探讨幽门螺杆菌(H.pylori)感染、血清胃泌素(GAS)与结肠腺瘤的相互关系.方法:采用放射免疫法(RIA)测定结肠腺瘤(n=48)及对照组(n=43)的血清胃泌素水平,用ELISA法检测H.pyloriIgG抗体.给予结肠腺瘤患者口服塞来昔布6mo,分别在2、4、6mo检测血清胃泌素及抗H.pyloriIgG抗体.结果:腺瘤组患者H.pylori感染阳性率、血清胃泌素水平明显高于对照组(P<0.05),结肠腺瘤组血清胃泌素水平与H.pyloriIgG抗体显著相关(r=0.854,P<0.001);远端结肠腺瘤患者H.pylori阳性率显著高于近端结肠(P<0.05),同时高胃泌素血症患者比例明显高于近端结肠(72.7%vs37.8%,P<0.05).口服塞来昔布后,H.pylori阳性率、血清胃泌素水平均趋向下降并且随着服药时间的延长进一步降低.结论:H.pylori感染可诱导高胃泌素血症与结肠腺瘤形成;COX-2可能介导胃泌素诱导的结肠腺瘤形成;口服COX-2抑制剂塞来昔布可以降低H.pylori阳性率及血清胃泌素水平,从而发挥抑制结肠腺瘤生长的作用.
Objective: To investigate the relationship between H. pylori infection, serum gastrin (GAS) and colon adenomas. Methods: Radioimmunoassay (RIA) was used to measure colon adenoma (n=48) and control group ( Serum gastrin levels of n=43) were measured by ELISA for H.pylori IgG antibodies. Patients with colonic adenoma received oral celecoxib for 6 months and serum gastrin and anti-H.pylori IgG antibodies were detected at 2, 4, and 6 months, respectively. Results: The positive rates of H.pylori infection and serum gastrin levels were significantly higher in the adenoma group than in the control group (P<0.05). Serum gastrin levels in the colon adenoma group were significantly associated with H.pylori IgG antibody (r=0.854). (P<0.001); The positive rate of H.pylori in patients with distal colon adenoma was significantly higher than that in the proximal colon (P<0.05), while the proportion of patients with hypergastrinemia was significantly higher than that in the proximal colon (72.7% vs37.8). %, P<0.05). After oral administration of celecoxib, H. pylori positive rate, serum gastrin levels tend to decrease and decrease further with prolonged administration. Conclusion: H. pylori infection induces hypergastrin Hyperlipidemia and colon adenoma formation; COX-2 may mediate gastrin-induced colon adenoma formation; oral COX-2 inhibitor celecoxib can reduce the positive rate of H.pylori and Serum gastrin levels, which play a role in inhibiting the growth of colon adenomas.