幽门螺杆菌感染对舌苔菌群的影响

探讨慢性萎缩性胃炎患者和慢性浅表性胃炎患者胃内幽门螺杆菌(Helicobacter pylori, H.pylori)感染与舌苔菌群的关系。

根据61名患者内镜、病理和H.pylori检测结果, 将其分成慢性萎缩性胃炎H.pylori阳性组(12名)、慢性萎缩性胃炎H.pylori阴性组(16名)、慢性浅表性胃炎H.pylori阳性组(8名)和慢性浅表性胃炎H.pylori阴性组(25名)。采集舌苔样本进行16S rRNA基因测序, 分析各组患者舌苔菌群结构。

16S rRNA基因测序结果显示, 此次测序样本数据量足够, 样本所含物种的丰富程度和均匀程度合理。4组舌苔菌群样本中Observed species指数差异有统计学意义(H=10.023 3, P < 0.05)。门水平上, 舌苔菌群由拟杆菌门、厚壁菌门、变形菌门3大优势菌门组成。属水平上, 4组间共有11种菌属的丰度差异有统计学意义(均P < 0.05)。在慢性萎缩性胃炎患者中, H.pylori阳性的患者拟普雷沃菌属相对丰度显著低于H.pylori阴性患者, 而罗氏菌属的相对丰度则显著升高。此外, 61例舌苔菌群样本中, 仅1例检测到H.pylori。

H.pylori感染与舌苔菌群结构存在相关性, 然而胃内与口腔中H.pylori的具体关联还需要进一步研究。

     

抗坏血酸对幽门螺杆菌相关萎缩性胃炎小鼠的干预

目的研究不同浓度抗坏血酸(ascorbic acid)溶液对幽门螺杆菌(Helicobacter pylori,H.pylori)相关萎缩性胃炎小鼠模型的作用。方法将C57BL/6小鼠随机分为5组,每组10只。组1为空白对照组,余4组小鼠用幽门螺杆菌悉尼菌株(Helicobacter pylori-Sydney strain 1,H.pylori-SS1)感染2周,快速尿素酶法和免疫组织化学法检测H.pylori-SS1的定植;组3、组4和组5小鼠分别给予抗坏血酸低倍剂量(0.1 g/L)、中倍剂量(0.5 g/L)和高倍剂量(1.0 g/L)灌胃22周。灌胃结束后,处死所有小鼠取胃组织和血清,H&E染色观察组织学变化,ELISA检测血清胃泌素(gastrin)和白介素8(IL-8)水平。结果与H.pylori组相比,抗坏血酸干预组胃组织萎缩程度减轻、血清胃泌素水平升高、炎症因子水平降低(组2 vs组3:F=21.730,P=0.029;组2 vs组3:F=42.781,P=0.015;组2 vs组3:F=35.720,P=0.021),中倍剂量组较低倍剂量组有更显著的作用(组3 vs组4:F=21.730,P=0.041;组3 vs组4:F=42.781,P=0.034;组3 vs组4:F=35.720,P=0.043),但高倍剂量组与中倍剂量组差异无统计学意义(组4 vs组5:F=21.730,P=0.125;组4 vs组5:F=42.781,P=0.391;组4 vs组5:F=35.720,P=0.450)。结论抗坏血酸干预可减轻小鼠H.pylori相关萎缩性胃炎症状,高剂量抗坏血酸与中低剂量比无显著差异。     

慢性萎缩性胃炎患者肠道菌群特征

探讨不同炎症程度慢性萎缩性胃炎（CAG）患者肠道菌群特征,为该类患者的治疗提供参考。

对36例健康人（健康对照组）和8例轻度炎症（轻度炎症组）、26例中度炎症（中度炎症组）、8例重度炎症（重度炎症组）的CAG患者的粪便样本进行16S rRNA基因高通量测序（V4—V5区）,采用Sobs、Shannon、Simpson、Ace、Chao指数评估4组对象肠道菌群的物种丰富度与多样性;采用PLS-DA分析评估4组对象肠道微生物群落结构;采用LDA与LEfSe分析确定4组对象相对丰度存在显著差异的肠道菌群;采用PICRUSt预测CAG患者显著富集肠道菌属的代谢通路信息。

与健康对照组相比,轻、中、重度炎症组患者肠道菌群Sobs、Ace、Chao、Simpson指数有降低趋势,但差异均无统计学意义（均P＞0.05）。Ruminococcus_gnavus_group、norank_f_Ruminococcaceae、Erysipelatoclostridium、Actinomyces在轻度炎症组中显著富集,Flavonifractor、Sellimonas在中度炎症组中显著富集,Eubacterium_rectale_group、Erysipelotrichaceae_UCG-003、Tyzzerella_3、Coprococcus_1、Candidatus_Soleaferrea在重度炎症组中显著富集。此外,Lachnospiraceae_UCG-004、Eubacterium_nodatum_group的丰度在健康对照组、轻度炎症组、中度炎症组、重度炎症组中呈递增趋势;Anaerostipes、Ruminiclostridium_9、Halomonas、Pelagibacterium的丰度在健康对照组、轻度炎症组、中度炎症组、重度炎症组中呈递减趋势,但差异均无统计学意义（均P＞0.05）。PICRUSt分析结果显示4组对象肠道菌群代谢通路相似,但是代谢通路的丰度不同,其中重度炎症组患者肠道菌群代谢功能潜力高于健康对照组、轻度炎症组和中度炎症组。

CAG患者肠道菌群变化的总体特征为产丁酸盐的菌属丰度减少,促炎菌属的丰度增加。促炎菌属可能通过附着于肠道上皮导致黏膜屏障受损和肠道通透性增加,影响宿主免疫反应,引起炎症。

     

番茄红素通过上调Nrf2-Ho-1/Nqo1蛋白表达治疗幽门螺杆菌相关慢性萎缩性胃炎

探讨番茄红素（LYC）对慢性萎缩性胃炎（CAG）的治疗作用及其潜在作用机制。

通过网络数据库筛选出CAG致病靶点与LYC作用靶点并取交集,通过String数据库构建蛋白互作网络,并使用Cytoscape进行可视化分析。最后通过对LYC治疗CAG可能核心靶点基因进行GO功能和KEGG通路富集分析筛选关键通路进行实验验证。构建CAG实验小鼠模型,在LYC干预后通过H&;E染色、ELISA、免疫组织化学染色、RT-qPCR检测及Western Blot等实验方法评估LYC对CAG的治疗作用及其可能作用机制。

LYC与CAG共同靶点77个,通过GO功能和KEGG通路富集分析发现主要涉及的通路有氧化应激反应、对活性氧的反应等。使用KEGG Pathview绘制Chemical carcinogenesis-reactive oxygen species通路途径,发现ROS-Nrf2-Ho-1/Nqo1通路作用较为显著。H&;E染色和血清胃泌素结果提示CAG小鼠模型构建成功;与模型组相比,LYC干预后小鼠血清胃泌素水平较模型组显著下降,胃黏膜萎缩程度显著减轻,小鼠胃组织中超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶抗氧化蛋白水平显著上调,丙二醛水平显著下降;免疫组化、RT-qPCR检测及Western Blot结果共同提示与模型组相比,LYC干预后小鼠胃组织中Nrf2、Ho-1、Nqo1 mRNA和蛋白水平显著上调。

LYC可通过提高小鼠胃黏膜抗氧化应激能力以及上调ROS-Nrf2-Ho-1/Nqo1通路蛋白表达从而发挥治疗CAG的目的。

     

枳术宽中胶囊联合益生菌对老年幽门螺杆菌阳性慢性萎缩性胃炎患者的疗效

目的 探讨枳术宽中胶囊联合益生菌对老年幽门螺杆菌（H. pylori）阳性慢性萎缩性胃炎（chronic atrophic gastritis,CAG）患者的临床疗效。方法 将80例H. pylori阳性的老年慢性萎缩性胃炎患者随机分为2组,各40例。其中对照组患者给予包含雷贝拉唑、阿莫西林、克拉霉素和胶体果胶铋的标准四联疗法治疗。观察组患者将四联疗法中的胶体果胶铋替代为枳术宽中胶囊,并在此基础上加用益生菌。7天为1个疗程,全部患者治疗2个疗程。停药1个月后比较两组患者治疗前后临床症状缓解率、H. pylori根除率、不良反应发生率等情况。结果 治疗后两组患者病情均有所改善,但与对照组相比,观察组患者的症状缓解率及H. pylori根除率较高,不良反应发生率较低,差异均有统计学意义（P<0.05）。结论 枳术宽中胶囊联合益生菌可明显缓解老年CAG患者的临床症状,提高幽门螺杆菌的根除率,同时减轻患者不良反应发生率,对临床治疗CAG具有指导性意义。     

慢性多灶萎缩性胃炎患者胃酸分泌与Hp感染及血清胃泌素的关系

目的:探讨多灶萎缩性胃炎(BAG)患者胃酸分泌与幽门螺杆菌(HP)感染及血清胃泌素水平的关系。方法:根据病理结果将60例确诊的慢性BAG患者分为轻度、中度、重度BAG组,监测各组患者24小时胃内PH值的变化、血清胃泌素水平及HP感染情况。结果:随着萎缩程度的加重,HP阳性率、胃内中位PH值及算数均数p H值逐渐升高,血清胃泌素水平逐渐降低;轻度、中度、重度BAG组组间中位p H值、算数均数p H值及血清胃泌素水平比较有显著差异(均P0.05);重度BAG组HP感染与轻度组、中度组比较有统计学差异(均P0.05),而轻度组HP感染与中度组差异无统计学意义(P0.05)。结论:随着慢性BAG萎缩程度的加重,HP阳性率和p H值逐渐升高,血清胃泌素水平逐渐降低。HP感染、胃泌素水平及胃酸分泌水平三者相互影响,相互作用。     

氧化应激与幽门螺杆菌感染相关性胃炎

幽门螺杆菌(Helicobacter pylori,H.pylori)是一种选择性定植于胃上皮细胞的革兰氏阴性菌,是一种广泛传染的病原菌,也是诱导产生慢性胃炎的主要因素之一。近年来研究表明幽门螺杆菌感染诱导机体产生氧化应激反应,并通过各种逃逸机制避免被杀灭。幽门螺杆菌能不断刺激中性粒细胞和巨噬细胞表达活性氧和活性氮,导致体内活性氧和活性氮的过度积累,致使细胞的凋亡和胃粘膜损伤的加剧,这是导致胃炎发生及加重的重要因素。本文对幽门螺杆感染引起氧化应激反应的研究进展作简要综述。     

幽门螺杆菌相关胃炎患者唾液菌群的研究

目的 探究幽门螺杆菌（Helicobacter pylori,H. pylori）相关胃炎（HpAG）患者和健康人群的唾液菌群特征,找出HpAG患者与无H. pylori感染人群唾液菌群之间的差异。方法 选取符合纳入标准的门诊及住院HpAG患者30例（HP组）,无H. pylori感染者30例（HC组）,收集2组人群唾液标本,通过PCR法扩增16S r RNA基因V3―V4区,经过高通量测序后,对测序数据处理后进行ASV注释、群落结构及多样性分析。结果 群落结构分析表示HpAG患者有其特征性的菌群结构。门水平上,HC组与HP组患者均以拟杆菌门（Bacteroidota）、变形菌门（Proteobacteria）、厚壁菌门（Firmicutes）、梭杆菌门（Fusobacteriota）和放线菌门（Actinobacteriota）为主要优势菌门。与HC组比较,HP组患者唾液菌群中Fusobacteriota相对丰度显著增加（t=2.01,P<0.05）。属水平上,HC组与HP组患者均以普雷沃菌属（Prevotella）、奈瑟菌属（Neisseria）、嗜血杆菌属（Haemophi...     

慢性萎缩性胃炎患者舌苔菌群的特异性菌属分析

目的 通过对慢性萎缩性胃炎患者和正常人舌苔菌群的分析,寻找两者之间的差异菌属。方法 研究分为两组：慢性萎缩性胃炎患者组（30例,CAG组,主要为薄白苔）和正常人舌苔组（30例,HC组,均为薄白苔）,采用16S rRNA基因测序技术对舌苔的菌群进行研究。结果 （1）测序片段总长度约为253 bp,片段有效率在90%左右。（2）正常组与慢性萎缩性胃炎组的群落组成在PCA图中各自汇聚成群,差异比较明显。（3）按照系统分类学的方法,采用LEfSe多级物种差异判别分析来寻找阶元系统（门、纲、目、科、属）上的差异菌,发现共有13种差异菌。慢性萎缩性胃炎在纤毛菌属、韦荣球菌属中的含量显著增加（P<0.05）;链球菌属的含量显著降低（P<0.05）。（4）为了进一步寻找阶元系统中属水平的差异菌属,我们采用T-test统计分析法。结果表明慢性萎缩性胃炎组在韦荣球菌属、纤毛菌属、普氏菌属、罗思菌属、口腔杆菌属、口腔毛绒厌氧杆菌、Solobacterium和一种未确认种属的细菌其含量都显著增加（P<0.05),而链球菌属的含量显著降低（P<0.05）。结论 从舌苔样本微生态测序中发现,慢性萎缩性胃炎患者的舌苔菌群发生变化,微生物的代谢产物可能与炎症相关,这些口腔微生物的变化可能成为某些全身疾病,尤其是消化系统疾病的微生物学指征。     

儿童慢性牙周炎与口腔幽门螺杆菌感染的相关性

目的 探讨慢性牙周炎患儿与其口腔中幽门螺杆菌(Helicobacter pylori, H. pylori)的相关性,为儿童慢性牙周炎的临床治疗提供指导。 方法 分别随机选取2017年5月-2019年5月来我院口腔科就诊的慢性牙周炎患儿和牙周健康的儿童作为观察组(92例)和对照组(92例)。应用PCR技术检测采集的牙菌斑和含漱液样品中的H. pylori,并比较两组儿童口腔H. pylori检出率的差异及龈上、龈下菌斑中的分布情况以及不同程度牙周炎患儿检出率的差异。 结果 观察组患儿口腔中H. pylori的检出率明显高于对照组,两组之间差异有统计学意义(χ2=9.588 1,P2= 58.119 9,P2=19.783 1,P结论 口腔中H. pylori可能在儿童慢性牙周炎致病过程具有一定的促进作用,二者具有相关性。     

Prevalence and risk factors of atrophic gastritis and intestinal metaplasia in a Korean population without significant gastroduodenal disease

Background and Aim: The prevalence of gastric cancer and Helicobacter pylori infection is unacceptably high in Korea. This study was performed to evaluate the prevalence of atrophic gastritis (AG) and intestinal metaplasia (IM) and to identify their risk factors with respect to H. pylori virulence factors, and environmental and host factors, in Korean population without significant gastroduodenal disease.
Methods: The study cohort consisted of 389 subjects (≥ 16 years). AG and IM were scored histologically using the Sydney classification in the antrum and body, respectively. Prevalences and bacterial factors (i.e. cagA , vacA m1, and oipA ), environmental factors (i.e. smoking and alcohol), and host factors (i.e. genetic polymorphisms of IL-1B- 511, IL-1RN , TNF-A -308, IL-10 -592, IL-10 -819, IL-10 -1082, IL-8 -251, IL-6 -572, GSTP1 , p53 codon 72, and ALDH2 ) were evaluated.
Results: Prevalences of AG in the antrum and body were 42.5% and 20.1%, and those of IM were 28.6% and 21.2%, respectively. The presences of AG and IM were significantly higher in H. pylori -positive than in the H. pylori -negative subjects. Multivariate analysis showed that the risk factors for AG were H. pylori infection, age ≥ 61 years, and cagA and vacA m1 positivity. For IM the risk factors were H. pylori infection, age ≥ 61 years, a smoking history (rather than current smoking), strong spicy food, occupation (unemployed or nonprofessional vs. professional), and the presence of IL10- 592 C/A as opposed to A/A. In addition, IL6- 572 G carrier was found to have a protective effect against IM development as compared with C/C.
Conclusion: H. pylori infection was most important risk factor of AG and IM. Bacterial factors were found to be important risk factor for AG but environmental and host factors were more important for IM.     

反流性食管炎患者口腔菌群变化及其与幽门螺杆菌感染的关系

探讨反流性食管炎（RE）患者口腔菌群变化及其与幽门螺杆菌（H. pylori）感染的关系,为该类患者的治疗提供参考。

选择南京同仁医院2019年5月至2021年5月收治的140例RE患者为研究对象,将A、B级RE患者纳入AB组,C、D级纳入CD组;同时将患者分为合并H. pylori感染组和未合并H. pylori感染组。以一次性无菌收集管收集患者唾液标本,使用Illumina Hiseq 2500高通量测序平台对合格文库进行双端测序。

AB组患者H. pylori阳性率（16.67%）低于CD组（45.45%）。AB组患者口腔菌群Chao 1指数和Shannon指数均高于CD组,Simpson指数低于CD组（均P＜0.05）。未合并H. pylori感染组患者口腔菌群Chao 1指数和Simpson指数高于合并H. pylori感染组,Shannon指数低于合并H. pylori感染组（均P＜0.05）。未合并H. pylori感染组患者口腔放线菌门、放线菌属相对丰度高于合并H. pylori感染组,拟杆菌门相对丰度低于合并H. pylori感染组（均P＜0.05）。

RE病情较重者和合并H. pylori感染者表现为口腔菌群α多样性降低和门、属水平菌群相对丰度改变,合并H. pylori感染对RE患者病情和口腔菌群会产生一定影响。

     

229例慢性胃炎患者幽门螺杆菌培养及耐药情况

目的了解慢性胃炎患者H.pylori感染及其耐药情况,为临床治疗提供参考。方法慢性胃炎患者胃镜活检标本培养分离H.pylori,对分离的H.pylori采用纸片扩散法进行耐药性检测。结果229例患者分离出97株H.pylori;H.pylori分离阳性率为42．36％（97／229）,其中男性分离率为43．79％（67／153）,女性分离率为39．47（30／76）;92株H.pylori对抗生素的耐药性分别为：甲硝唑8．7％,克拉霉素7．6％,阿莫西林1．1％、呋喃唑酮1．1％,阿奇霉素4．4％,左氧氟沙星0％。结论慢性胃炎患者H.pylori感染率较高,但与性别、年龄无关;慢性胃炎H.pylori对常用抗生素敏感,建议采用左氧氟沙星、阿莫西林、呋喃唑酮进行治疗。     

Predictive factors for improvement of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication: a three-year follow-up study in Korea

Background and Aims: To date, data on the effects of anti‐Helicobacter therapy on the improvement of atrophic gastritis (AG) and intestinal metaplasia (IM) have been conflicting. This study was performed to investigate whether eradication of H. pylori could lead to the improvement of AG and IM, and the prognostic factors associated with the improvement of AG and IM. Methods: Four hundred patients consisting of H. pylori‐negative (n = 116) and H. pylori‐positive (n = 284) groups were followed up 1 and 3 years after initial H. pylori tests. Serum levels of pepsinogen (PG), bacteria, environmental factors, and genetic polymorphisms were determined. Results: The grade of corpus atrophy decreased at 1 and 3 years after successful eradication (p < .001 and p = .033, respectively). However, there was no significant change in the IM in the antrum and in the corpus. Prediction factors for the improvement of corpus AG by H. pylori eradication were baseline low PG I/II ratio (≤3), high salt intake, and corpus‐predominant gastritis. IM improvement was also associated with spicy food intake and high baseline grade of IM, in addition to these factors. In addition, IL‐1B‐511 C/T and IL‐6‐572 C/G alleles were found to inhibit IM improvement. However, H. pylori‐negative and noneradicated group did not show any significant change in AG or IM. Conclusion: Corpus AG was reversed by H. pylori eradication, and improvement of IM by H. pylori eradiation was more definite in patients with severe IM, low PG I/II ratio, and corpus‐predominant gastritis, suggesting that H. pylori eradication is valuable even in severe cases.     

Diversity of Helicobacter pylori cagA and vacA genes in Costa Rica: its relationship with atrophic gastritis and gastric cancer

BACKGROUND: Associations between Helicobacter pylori gene diversity and gastric cancer have not been reported on in Costa Rica, despite its being one of the countries with the highest gastric cancer incidence and mortality rates in the world. The aim of this study was to determine the prevalence of H. pylori cagA and vacA genes and investigate whether it could be correlated with atrophic gastritis (AG) and gastric cancer (GC) in Costa Rica. MATERIALS AND METHODS: Genomic DNAs from isolates of 104 patients classified into two groups: non-atrophic gastritis group (n = 68) and atrophic gastritis group (n = 36), were subjected to PCR-based genotyping of cagA and vacA genes and their correlation with clinical outcome was investigated. Total DNA extractions from gastric tissues of 25 H. pylori-infected gastric cancer patients were utilized for comparative purposes. RESULTS: The presence of cagA (75.3%), vacA s1b (75.3%), and vacA m1 (74.2%) was detected, and colonization by strains with different vacA genotypes in the same stomach was found in 9.7% of the patients. Age- and sex-adjusted vacA s1b and vacA m1 were associated with GC while only vacA m1 was significantly associated with AG. A tendency for association between cagA and vacA s1b, and AG was reported. CONCLUSIONS: The prevalence status of the cagA and vacA (s1/m1) genes in Costa Rica seems to fall between that found in European/North American and East Asian countries, and both cagA and vacA seem to have clinical relevance in this country.     

益生菌辅助四联疗法对H. pylori感染患者根治效果及肠道菌群的影响

研究益生菌辅助四联疗法对H. pylori感染患者根治效果及肠道菌群的影响。

选择2019年1月至2020年6月在我院接受治疗的160例H. pylori感染患者为研究对象,用随机数字表法分为对照组（n = 80）和观察组（n = 80）。对照组患者给予标准铋剂四联药物治疗,观察组加用双歧杆菌四联活菌片治疗。比较两组患者的H. pylori根除率、复发率、不良反应发生率、临床症状（上腹痛、上腹胀、嗳气、纳差）、肠道菌群（双歧杆菌、乳杆菌）和炎性因子[白细胞介素-6（IL-6）、白细胞介素-8（IL-8）及肿瘤坏死因子-α（TNF-α）]水平。

观察组患者的H. pylori根除率（95.00%）高于对照组（82.5%）,复发率和不良反应发生率低于对照组（均P＜0.05）。治疗后两组患者的临床症状积分均显著下降,同时观察组患者上腹痛、上腹胀、嗳气、纳差等临床症状积分低于对照组（均P＜0.05）。治疗后观察组患者肠道双歧杆菌和乳杆菌数量升高,而对照组降低,同时观察组患者肠道双歧杆菌和乳杆菌数量高于对照组（均P＜0.05）。治疗后观察组患者IL-6、IL-8和TNF-α水平均低于对照组（均P＜0.05）。

双歧杆菌四联活菌片辅助标准铋剂四联疗法治疗可显著提高H. pylori感染患者H. pylori根除率,降低复发率和不良反应的发生率,改善肠道菌群分布,减轻患者的临床症状和炎症状态。

     

Intragastric ascorbic but not uric acid is depleted in relation with the increased pH in patients with atrophic body gastritis and H. pylori gastritis

Background. Helicobacter pylori gastritis induces reversible lowering of Ascorbic Acid (AA) intragastric concentrations. No studies have been aimed at determining the gastric juice AA concentration of atrophic body gastritis (ABG) patients. Uric Acid (UA), is another potent hydro‐soluble scavenger of ROS and its possible modification in the gastric juice of patients with H. pylori gastritis have never been investigated. This study was aimed at investigating the levels of AA and UA in the plasma and gastric juice of ABG patients, compared with H. pylori positive patients without corporal atrophy, and with healthy individuals. Materials and Methods. Thirteen ABG patients (Group 1): 32 Chronic non‐atrophic H. pylori gastritis patients (Group 2); and 13 healthy stomach controls (Group 3) attending gastroscopy with gastric biopsies (antrum = 3, corpus = 3) had plasma and intragastric levels of AA and UA measured. Results. Intragastric AA concentration was significantly lower in group 1 (median 0.21 µg/ml, range 0.1–24) compared both with groups 2 (median 5.5 µg/ml, range 0.1–33.2) (p = 0.043) and 3 (median 14.9 µg/ml, range 0.34–44.8) (p = 0.0028). Intragastric UA was not different between the three groups. Intragastric AA concentration resulted negatively correlated with the intragastric pH (Spearman r = ?0.47, p = 0.0003). In patients with gastritis (groups 1 and 2) there was a significant negative correlation between the sum of the Sydney Score variables in the body mucosa, and AA in the gastric juice (Spearman r = ?0.55; p = 0.0001). Conclusion. The study shows that intragastric pH is the key factor for the depletion of gastric juice AA observed in patients with corporal atrophy and to a lower extent with nonatrophic H. pylori gastritis.     

益生菌联合标准四联疗法对幽门螺杆菌感染再次治疗的疗效及其对炎症因子的影响

研究布拉酵母菌联合标准四联疗法对幽门螺杆菌(H.pylori)感染患者再次治疗的疗效及其对炎症因子的影响。

选取我院124例H.pylori感染患者, 按随机分配的方法分为A组和B组, 每组62例。A组患者给予阿莫西林胶囊1 000 mg/次, 2次/d; 呋喃唑酮100 mg/次, 2次/d; 雷贝拉唑40 mg/次, 2次/d; 胶体果胶铋干混悬剂150 mg/次, 4次/d, 疗程14 d。B组患者在A组治疗方案的基础上加用布拉酵母菌250 mg/次, 3次/d, 疗程14 d。在治疗过程中观察患者的不良反应发生情况。疗程结束完全停药4周后检测两组患者H.pylori根除及症状改善情况。对比治疗前后患者血清白介素-6(IL-6)、肿瘤坏死因子(TNF-α)、C-反应蛋白(CRP)水平。

观察组患者H.pylori的根除率、症状改善率和不良反应的发生率与对照组相比差异均有统计学意义(χ²=7.322、9.239、10.016, 均P < 0.05)。治疗后观察组患者血清IL-6、TNF-α、CRP水平较对照组降低(t=9.780、8.495、7.002, 均P < 0.05)。

布拉酵母菌联合标准四联疗法可提高H.pylori根除率, 改善患者症状, 降低不良反应发生率, 同时可降低血清炎症因子水平。