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目的观察青海高原幽门螺杆菌(Hp)相关性胃病患者血清Th1/Th2细胞因子(IL-1β、IL-2、IL-4、IL-6、IL-8、TNF)水平变化,以探讨其在发病中的可能免疫致病机制。方法用放射免疫法(RIA)测定57例慢性萎缩性胃炎(CAG)、55例消化性溃疡(PU)和35例进展期胃癌(GC)患者血清IL-1β、IL-2、IL-4、IL-6、IL-8、TNF的含量。比较Hp感染者三组胃病之间;Hp感染与非感染CAG之间;Hp感染CAG活动与非活动之间;Hp感染单纯CAG、IM、Dys之间;Hp感染与非感染PU之间及Hp感染与非感染GC之间血清6种细胞因子含量的差异。结果Hp相关性CAG和PU血清IL-4含量非常显著低于GC(P<0.01);Hp感染与非感染CAG之间6种细胞因子含量均无差异(P>0.05);Hp相关性CAG活动者血清IL-4含量显著低于非活者(P<0.05),IM和Dys均非常显著低于单纯CAG(P<0.01),IL-2在Dys显著高于单纯CAG(P<0.05);Hp感染PU血清IL-4非常显著低于非感染者(P<0.01);Hp感染GC血清IL-β1显著低于非感染者(P<0.05)。结论Hp感染对本地区CAG患者血清Th1/Th2平衡影响不大;Hp感染后IL-4分泌减少与CAG炎症活动和胃黏膜癌前病变(IM和Dys)及PU的发生密切相关,Th2弱势应答为其主要的免疫致病机制;Hp相关性进展期GC患者IL-β1分泌减少,Th1应答减弱,IL-4分泌增加,Th2应答上调,对机体具有明显的抗炎抗肿瘤和保护作用。
Objective To observe the changes of serum levels of Th1 / Th2 cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8 and TNF) in Helicobacter pylori (Hp) The possible pathogenesis of immune pathogenesis. Methods Serum levels of IL-1β, IL-2 and IL-4 in 57 cases of chronic atrophic gastritis (CAG), 55 cases of peptic ulcer (PU) and 35 cases of advanced gastric cancer (GC) were determined by radioimmunoassay (RIA) IL-6, IL-8, TNF levels. Between Hp infection and non-infected CAG; Between Hp infection CAG activity and inactivity; Hp infection between simple CAG, IM, Dys; Hp infection and non-infected PU and Hp Differences of serum cytokines levels between infected and noninfected GCs. Results Hp-related CAG and PU serum IL-4 levels were significantly lower than GC (P <0.01); Hp-related and non-infected CAG 6 cytokines content was no difference (P> 0.05); Hp-related CAG activity (P <0.05). The levels of IL-4 and IL-2 in serum were significantly lower than those in CAG alone (P <0.05). The level of IL-4 in serum of Hp-infected PU was significantly lower than that of non-infected (P <0.01). The serum level of IL-β1 in Hp-infected GC was significantly lower than that of non-infected (P <0.05). Conclusions Hp infection has little effect on the serum Th1 / Th2 balance in CAG patients. The decrease of IL-4 secretion after Hp infection is closely related to the inflammatory activity of CAG and the occurrence of precancerous lesions of gastric mucosa (IM and Dys) and PU. The weak response of Th2 is The main immune pathogenesis; Hp-related progressive GC patients with decreased secretion of IL-β1, Th1 response weakened, increased IL-4 secretion, Th2 response is up, the body has obvious anti-inflammatory anti-tumor and protective effect.