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目的:探讨H pylori感染及根除对慢性糜烂性胃炎患者IL-18水平的影响,同时检测抗H pylori治疗前后抗体水平的变化.方法:60例上消化道患者分两组,慢性糜烂性胃炎组(实验组)40例,慢性浅表性胃炎组(对照组)20例.实验组H pylori阳性者予口服洛赛克20 mg和克拉霉素500 mg及阿莫西林1000 mg,1 wk后症状缓解者,开始口服洛赛克20 mg/d至4 wk实验结束,对照组仅口服洛赛克抗H pylori治疗,1 mo后复查~(13)C呼气实验和胃镜.H pylori免疫印迹法进行蛋白抗体分型,同时ELISA法检测H pylori-IgG,IL-18水平.结果:治疗前H pylori阳性者实验组血清IL-18水平高于对照组(267.18±148.23 ng/L vs 119.31±45.34 ng/L:P<0.05).抗H pylori治疗后慢性糜烂性胃炎患者的IL-18,抗体水平均有明显下降(267.18±148.23 ng/L vs 93.82±22.15 ng/L;31.36±23.26 kU/L vs 21.00±9.47 kU/L;P<0.05).H pylori感染类型及糜烂的严重程度与IL-18水平无明显的相关性.结论:抗H pylori治疗后IL-18水平的下降在慢性糜烂性胃炎糜烂的治疗过程中发挥重要作用.
Objective: To investigate the effect of H pylori infection and eradication on the level of IL-18 in patients with chronic erosive gastritis and to detect the changes of antibody levels before and after treatment with anti-H pylori.Methods: Sixty patients with upper gastrointestinal tract were divided into two groups: chronic erosive gastritis group (Experimental group) 40 cases, chronic superficial gastritis group (control group) 20 cases.Experimental group H pylori positive were given oral Losec 20 mg and clarithromycin 500 mg and amoxicillin 1000 mg, 1 wk after the symptoms In the control group, only Losec was treated with anti-H pylori, and after 13 months, 13 C breath test and gastroscopy were performed.H pylori immunoblotting H pylori-IgG and IL-18 were detected by ELISA.Results: The level of serum IL-18 in H pylori positive group before treatment was higher than that in control group (267.18 ± 148.23 ng / L vs 119.31 ± 45.34 ng / L: P <0.05) .In patients with chronic erosive gastritis after anti-H pylori treatment, IL-18 and antibody levels were significantly decreased (267.18 ± 148.23 ng / L vs 93.82 ± 22.15 ng / L and 31.36 ± 23.26 kU / L vs 21.00 ± 9.47 kU / L, P <0.05) .H pylori infection type and the severity of erosions had no significant correlation with IL-18 levels.Conclusion: Anti-H Decreased levels of IL-18 after pylori treatment play an important role in the treatment of chronic erosive gastritis.