益生菌疗法根除不同分型H.pylori对胃泌素-17、胃蛋白酶原的影响
Effect of probiotic therapy on eradication of different types of H.pylori on gastrin-17 and pepsinogen
彭卫斌 1叶东雯 1黄晓雯 2沙卫红 3杨元生 1容海鹰 1聂玉强4
作者信息
- 1. 广州新海医院消化内科,广东广州 510300
- 2. 广州新海医院内分泌科
- 3. 广东省人民医院消化内科
- 4. 广州市第一人民医院消化内科
- 折叠
摘要
目的 探讨联合益生菌根除不同分型H.pylori对胃泌素-17(gastrin-17,G-17)、胃蛋白酶原(pepsinogen,PG)的影响.方法 将116例H.pylori阳性慢性胃炎患者随机分为四联疗法组和联合益生菌疗法组,疗程均为2周.选取H.pylori阳性健康体检者100名作为健康对照组.对H.pylori抗体CagA、VacA、UreA和UreB进行血清学检测,并检测治疗前后血清中PG Ⅰ、PG Ⅱ、PG Ⅰ/Ⅱ比值(PG Ⅰ/PG Ⅱ ratio,PGR)及G-17水平.结果 四联疗法组、联合益生菌疗法组及健康对照组的H.pylori Ⅰ型阳性率均高于H.pylori Ⅱ型,且两治疗组H.pylori Ⅰ型的阳性率明显高于健康对照组(P＜0.05);三组CagA+VacA抗体阳性率均高于各组CagA、VacA抗体阳性率(P＜0.05).三组VacA、UreA、UreB抗体阳性率均高于各组CagA抗体阳性率(P＜0.05).不同炎症程度慢性胃炎CagA、UreB抗体的阳性率差异均无统计学意义(P＞0.05);重度慢性胃炎与轻度慢性胃炎比较,VacA抗体阳性率显著升高,而UreA抗体阳性率显著下降(P＜0.05).治疗前,与H.pylori Ⅱ型感染者相比,三组H.pylori Ⅰ型感染者PG Ⅱ及G-17水平显著升高,PGR水平显著下降(P＜0.05),而PG Ⅰ水平差异无统计学意义(P＞0.05);治疗后,联合益生菌疗法组H.pylori Ⅰ型患者的PGⅠ、PG Ⅱ及G-17水平显著下降,PGR水平升高(P＜0.05).结论 H.pyloriⅠ型菌株是慢性胃炎的主要致病菌株,并且影响患者血清PG Ⅰ、PG Ⅱ、PGR及G-17的水平.联合益生菌疗法治疗H.pylori Ⅰ型慢性胃炎,能降低血清PG Ⅰ、PG Ⅱ、G-17水平,提高PGR水平.
Abstract
Objective To investigate the effect of the different types of H.pylori eradication combined with probiotic on gastrin-17(G-17)and pepsinogen(PG).Methods A total of 116 patients with H.pylori positive chronic gastritis were randomly divided into quadruple therapy group and combination probiotic therapy group.The course of treatment was 2 weeks.One hundred healthy people with positive H.pylori were selected as the healthy control group.Serum H.pylori-specific antibodies CagA,VacA,UreA and UreB were detected.The serum levels of PG Ⅰ,PG Ⅱ,PG Ⅰ/PG Ⅱ ratio(PGR)and G-17 were detected before and after treatment.Results The prevalence of H.pylori type Ⅰwas significantly higher than that of H.pylori type Ⅱ in the three groups(P＜0.05).The prevalences of H.pylori type I in two therapy groups were significantly higher than those in the healthy control group each(P＜0.05).The prevalence of CagA+VacA antibody was higher than that of CagA and VacA antibody in each group(P＜0.05).The prevalences of VacA,UreA and UreB antibodies were higher than that of CagA antibody in each group(P＜0.05).There were no sig-nificant differences in the prevalence of CagA and UreB antibody in chronic gastritis of different inflammatory degrees(P＞0.05).Compared with mild chronic gastritis group,the prevalence of VacA antibody in severe chronic gastritis group was increased significantly,while the prevalence of UreA antibody was decreased significantly(P＜0.05).Com-pared with H.pylori type Ⅱ infected persons,the levels of PG Ⅱ and G-17 in H.pylori type Ⅰ infected persons in each group increased significantly,and the PGR decreased significantly(P＜0.05),while the level of PG Ⅰ had no signifi-cant difference before treatment(P＞0.05).After the eradication of H.pylori,the levels of PG Ⅰ,PG Ⅱ and G-17 in H.pylori type Ⅰ patients in the combination probiotic therapy group decreased significantly,and the PGR increased(P＜0.05).Conclusion H.pylori type Ⅰ strain is the main pathogenic strain of chronic gastritis,and affects the lev-els of serum PG Ⅰ,PG Ⅱ,PGR and G-17 in patients.Combination probiotic therapy can significantly reduce the level of serum PG Ⅰ,PG Ⅱ,G-17,and increase the levels of serum PGR in patients with chronic gastritis of H.pylori type Ⅰ.
关键词
益生菌/幽门螺杆菌/幽门螺杆菌抗体/胃炎/胃蛋白酶原/胃泌素-17Key words
Probiotic/Helicobacter pylori/Helicobacter pylori antibody/Gastritis/Pepsinogen/Gastrin-17引用本文复制引用
基金项目
广东省医学科学技术研究项目(B2021262)
广东省医学科学技术研究项目(A2016406)
出版年
2024
NETL
NSTL
万方数据