消化性溃疡患者血管活性肠肽与十二指肠胃反流和幽门螺杆菌感染关系的研究

背景：消化性溃疡（PU）和十二指肠胃反流（DGR）患者的血浆血管活性肠肽（VIP）含量常高于正常水平，而幽门螺杆菌（H.pylori)感染可能参与PU的发病。目的：探讨PU患者的VIP和DGR和H.pylori感染的关系。方法：采用放射免疫测定（RIA）检测34例胃溃疡（GU）患者、42例十二指肠球部溃疡（DU）患者和30例健康人的血浆VIP含量；放射性核素^99mTc-EHIDA显像法测定DGR；双抗体夹心酶联免疫吸附测定（ELISA）检测血清H.pylori IgG抗体，Giemsa染色检测胃黏膜H.pylori。结果：GU组的血浆VIP含量显著高于DU组和正常对照组（P＜0．01）；DGR阳性率亦显著高于DU组（P＜0．05）。DGR阳性组的血浆VIP含量显著高于DGR阴性组（P＜0．01）。H.pyori阳性组的血浆VIP含量显著低于H.pylori阴性组（P＜0．05）。结论：PU患者血浆VIP含量升高可能是DGR发生的重要因素之一。

Study on the Relationship between Vasoactive Intestinal Peptide, Duodenogastric Reflux and Helicobacter pylori Infection in Patients with Peptic Ulcer

Background: High concentration of plasma vasoactive intestinal peptide (VIP) is usually seen in patients with peptic ulcer (PU) and duodenogastric reflux (DGR); and Helicobacter pylori (H. pylori) may be involved in the pathogenesis of PU. Aims: To explore the relationship between VIP, DGR and H. pylori infection in patients with PU. Methods: Plasma VIP concentration was determined by radioim-munoassay (RIA) in 34 gastric ulcer (GU) patients, 42 duodenal ulcer (DU) patients and 30 healthy subjects served as controls. DGR was determined by 99mTc-EHIDA radionuclide imaging, and H. pylori infection by detecting serum anti-H. pylori IgG using enzyme-linked immunosorbent assay (ELISA) and histology (Giemsa stain). Results: Plasma VIP concentration in GU group was significantly higher than that of DU group and normal controls (P<0.01). The positivity rate of DGR in GU group was also markedly higher than that of DU group (P<0.05). Plasma VIP in patients with DGR was markedly higher than that of non-DGR patients (P<0.01), but was markedly lower in H. pylori-positive group than that of H. pylori-negative group (P<0.05). Conclusions: VIP may play an important role in the pathogenesis of DGR in patients with PU.