论文部分内容阅读
目的 :探讨洛赛克、克拉霉素、替硝唑三联疗法治愈的十二指肠球部溃疡 (DU)“再生”粘膜组织成熟度和IL- 10、IL- 12的水平。方法 :将 64例幽门螺杆菌 (HP)阳性 DU患者随机分成 2组 :A组 3 6例 ,应用洛赛克 2 0 mg+克拉霉素 5 0 0 mg+替硝唑 5 0 0 mg,bid,共 1周 ;B组 2 8例 ,采取雷尼替丁 15 0 mg bid+阿莫西林 5 0 0 mg、甲硝唑 4 0 0 mg,tid,共 4周。停药 4～ 6周后复查胃镜 ,从 DU边缘或溃疡疤痕处活检粘膜组织以备组织学检查及 IL- 10、IL- 12的测定。用快速尿素酶试验和美蓝染色来检查 HP。结果 :A组溃疡愈合率 90 .91% ,显著高于 B组的 69.2 3 % (P<0 .0 5 ) ;A组 HP根除率也明显高于 B组 (93 .90 % vs69.2 3 % ,P<0 ,0 5 )。从再生粘膜组织成熟度来看 ,A组 73 .3 3 %为“良”,而 B组为“良”者仅 3 3 .3 3 % ,P<0 .0 1。A、B组治疗前球部粘膜 IL- 10水平均高于对照组 ,IL- 12水平也都高于对照组 ;治疗后 A组 IL-10的水平显著高于 B组和对照组 ,IL- 12水平恢复到正常水平 ;B组 IL- 10、IL- 12的水平基本上也恢复到正常水平。结论 :洛赛克、克拉霉素、替硝唑三联疗法治愈的组织成熟度优于含雷尼替丁方案。其可能抑制 IL- 12分泌 ,而促进 IL- 10的分泌 ,使 IL- 10在溃疡愈合后的一段时间内维持在较
Objective: To investigate the “mucosal tissue maturation and the levels of IL-10 and IL-12 in duodenal ulcer (DU)” mucosa cured by triple therapy with Losec, clarithromycin and tinidazole. Methods: Sixty-four patients with Helicobacter pylori (HP) -positive DU were randomly divided into two groups: group A (36 cases), with Losec 20 mg + clarithromycin 500 mg + tinidazole 500 mg bid 1 week; Group B, 28 cases, taking ranitidine 15 0 mg bid + amoxicillin 500 mg, metronidazole 4 0 0 mg, tid for 4 weeks. Gastric endoscopy was performed 4 to 6 weeks after drug withdrawal and mucosal tissue was biopsied from the edge of DU or ulcer scar for histological examination and determination of IL-10 and IL-12. HP was examined by rapid urease test and methylene blue staining. Results: The healing rate of ulcer in group A was 90.91%, which was significantly higher than 69.2 3% in group B (P <0.05); the eradication rate of group A was also significantly higher than that in group B (93.90% vs 69.23 %, P <0, 0 5). In terms of the maturity of regenerative mucosa, 73.33% of patients in group A were “good”, and 33.3% of patients in group B were “good” (P <0.01). The levels of IL-10 in group A and B before treatment were significantly higher than those in control group, and the levels of IL-12 in group A and B were also higher than those in control group. After treatment, the level of IL-10 in group A was significantly higher than that in group B and control group, 12 levels returned to normal levels; B group IL-10, IL-12 levels basically returned to normal levels. Conclusion: Tissue maturation of Losec, Clarithromycin and Tinidazole triple therapy is better than that of ranitidine-containing regimen. It may inhibit the secretion of IL-12 and promote the secretion of IL-10 so that IL-10 is maintained at a relatively low level for a period of time after ulcer healing