不同分型Hp感染消化性溃疡患者血清IL-10、IL-17、TNF-α水平及临床意义

摘要

Objective To observe the serum levels of interleukin-10 (IL-10), interleukin-17 (IL-17), tumor necrosis factor-α (TNF-α) in patients with peptic ulcer infected by different Helicobacter pylori strains, and explore their clinical significance in the diagnosis and treatment of peptic ulcer (PU). Methods A total of 170 PU patients, who admitted to Department of Gastroenterology of Mawangdui Hospital of Hunan Provincial People's Hospital from June 2015 to December 2016, were selected as the research subjects. The serum levels of IL-10, IL-17 and TNF-αof patients were detected by ELISA, and different Helicobacter pylori strains were detected by Western blot. Then the differences of IL-10, IL-17 and TNF-αamong different Helicobacter pylori strains and types were comparatively an-alyzed. Results Among 170 PU patients, 97 cases of typeⅠwas found detected by Western blot (57.06%), as well as 26 cases of typeⅡ(15.29%), and 47 cases of Helicobacter pylori negative (27.65%). The serum levels of IL-10, IL-17 and TNF-αin Helicobacter pylori typeⅠgroup were (32.35±8.64) pg/mL, (56.21±12.46) pg/mL, (44.36+11.28) pg/mL, re-spectively, which were significantly higher than (21.17±7.21) pg/mL, (36.06±8.62) pg/mL, (30.23±8.10) pg/mL in Heli-cobacter pylori typeⅡgroup and (18.56 ± 7.56) pg/mL, (22.34 ± 7.5) pg/mL, (14.84 ± 6.35) pg/mL in Helicobacter pylori negative group (P<0.05). There was no significant difference in the serum levels of IL-10 of gastric ulcer, duodenal ul-cer and compound ulcer in each genotype groups (P>0.05). The serum levels of IL-17 in compound ulcer were signifi-cantly higher in patients with gastric ulcer and duodenal ulcer (P<0.05). There was significant difference in serum levels of TNF-αbetween the patients of gastric ulcer, duodenal ulcer and compound ulcer infected by Helicobacter pylori typeⅠ(P<0.05). Conclusion There are significant difference in serum levels of IL-10, IL-17 and TNF-αof PU patients in-fected by different Helicobacter pylori strains, the detection of these items may help identify Helicobacter pylori genotypes, and provide reference for the diagnosis and treatment of diseases.%目的 观察不同分型Hp感染消化性溃疡(PU)患者血清白介素-10(IL-10)、白介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平,并探讨其在PU诊断和治疗中的临床意义.方法 选择2015年6月至2016年12月湖南省人民医院马王堆院区消化内科收治的PU患者170例,采用ELISA法检测PU患者血清中IL-10、IL-17、TNF-α含量,免疫印迹法鉴定Hp基因型,对比分析IL-10、IL-17、TNF-α在不同分型Hp感染消化性溃疡及部位中的差异.结果 在170例PU患者中,HpⅠ型97例(57.06%),HpⅡ型26例(15.29%),Hp阴性47例(27.65%).HpⅠ型组患者血清中IL-10、IL-17和TNF-α水平分别为(32.35±8.64)pg/mL、(56.21±12.46)pg/mL、(44.36+11.28)pg/mL,明显高于HpⅡ型组的(21.17±7.21)pg/mL、(36.06±8.62)pg/mL、(30.23±8.10)pg/mL和Hp阴性组的(18.56±7.56)pg/mL、(22.34±7.5)pg/mL、(14.84±6.35)pg/mL,差异均有统计学意义(P<0.05);各基因型组胃溃疡、十二指肠溃疡和复合性溃疡患者血清中IL-10水平比较差异均无统计学意义(P>0.05);各基因型组复合性溃疡血清中IL-17水平均明显高于胃溃疡和十二指肠溃疡,差异均有统计学意义(P<0.05);HpⅠ型组胃溃疡、十二指肠溃疡和复合性溃疡患者血清中TNF-α水平比较差异均有统计学意义(P<0.05).结论 不同分型Hp感染PU患者血清中IL-10、IL-17和TNF-α水平具有一定的差异,有助于Hp分型鉴别据.