高原地区幽门螺杆菌相关溃疡血清白细胞介素-2和白细胞介素-4水平变化及意义

目的测定青海地区幽门螺杆菌(Hp)相关溃疡患者血清白细胞介素-2(IL-2)和白细胞介素-4(IL-4)的水平,观察根除Hp治疗对其的影响,以探讨Hp在溃疡发病中的可能免疫致病机制,为临床治疗提供理论依据。方法应用放射免疫法测定55例(Hp感染30例,非Hp感染25例)溃疡患者血清IL-2和IL-4的含量,比较Hp感染与非感染患者其含量的差异,对Hp阳性者进行以洛赛克为中心的三联根除治疗,比较Hp根除前、后及Hp根除者和未根除者其含量的差异,同时比较Hp根除组和未根除组溃疡的愈合率。结果Hp感染者血清IL-4含量明显低于非感染者(P<0.01),Hp根除后明显高于根除前(P<0.001),Hp未根除者前后无变化(P>0.05),Hp根除者明显高于未根除者(P<0.05),Hp根除组溃疡愈合率明显高于Hp未根除组(P<0.05)。而IL-2在Hp感染者与非感染者中差异无显著性(P>0.05),根除Hp治疗对其亦无明显影响(P>0.05)。结论Hp感染后IL-4分泌减少引起的TH2弱势应答为本地区Hp相关性溃疡发生的主要免疫致病机制,对Hp阳性的溃疡患者进行根除Hp治疗可调节优势免疫应答类型和TH1/TH2平衡,从而达到治疗疾病的目的。

Significance of serum IL-2 and IL-4 of the patients with helicobacter pylori-related ulcer in highland area

Objective To detect the levels of serum IL-2 and IL-4 of the patients with helicobacter pylori-related ulcer in Qinghai area and to observe the effect of Hp eradication on the mand explore the mechanism of Hp in ulcer.Methods IL-2 and IL-4 levels of 55 cases(30 cases of Hp infection and 25 cases of non-Hp infection)were detected by radioimmunity assay.The differences of IL-2 and IL-4 between the Hp-infection group and non-Hp infection group were compared.Hp was eradicated in the Hp positive patients by Luosange-centered therapy and then the levels of IL-2 and IL-4 were compared in the patients with Hp eradication and without Hp eradiation,meanwhile the curing rate of ulcer in the two groups was analyzed.Results IL-4 levels in Hp-infection group were obviously lower than that in non-Hp infection group(P<0.01),which was obviously increased after eradication(P<0.001)but did not change in the patients without Hp eradication(P>0.05),which was obviously higher in Hp eradication group than that in group without Hp eradication(P<0.05)and the curing rate of ulcer was obviously higher in Hp eradication group than in group without Hp eradication(P<0.05).IL-2 was not significantly changed both in the patients with Hp infection and without Hp infection(P>0.05).Conclusion The main immunity mechanism of Hp-associated ulcer is the weak response of TH2 caused by the decreased secretion of IL-4 after Hp infection,so Hp eradication for the Hp positive patients with ulcer will regulate the immune response type and TH1/TH2 balance.