幽门螺杆菌感染和血清胃泌素-17与直肠息肉相关性研究

杨波; 李心洁; 王彦人; 田雅军; 罗毅

doi:10.3969/j.issn.1671-038X.2019.05.12

幽门螺杆菌感染和血清胃泌素-17与直肠息肉相关性研究

- 解放军杭州疗养院全军健康管理专科中心, 浙江杭州 310007
基金项目:
中国健康促进基金会项目 (No:CHPF2014-STL)

详细信息

作者简介:
杨波, 男, 主治医师, 研究方向:消化内科疾病

通讯作者: 田雅军, E-mail:tyj128@126.com

中图分类号: R574.63

收稿日期: 2018-12-01

The correlation of helicobacter pylori infection and serum gastrin-17 with rectal polyps

- Specialist Center for Health Management of PLA, Hangzhou Sanatorium of the People's Liberation Army, Hangzhou 310007, China

More Information

Corresponding author: TIAN Ya-jun, E-mail: tyj128@126.com

Received Date: 01 December 2018

摘要

摘要: [目的]探讨幽门螺杆菌 (helicobacter pylori, Hp) 感染、血清胃泌素-17 (gastrin-17, G-17) 水平与直肠息肉发生的相关性。[方法]回顾性分析2017年6月~2018年6月在我中心进行电子直乙肠镜检查人员1334例, 分为息肉组 (253例) , 对照组 (1081例) , 所有入选人群均行¹³C呼气试验 (¹³C-UBT) 检测, 以超基准值≥4.0即判断为Hp感染阳性;利用ELISA法定量测定空腹血清G-17的水平;[结果]直肠息肉组Hp感染阳性率及血清G-17水平均较对照组明显升高 (P<0.01) , 2组中Hp感染阳性者血清G-17水平均显著高于Hp感染阴性者 (P<0.01) ;根据息肉的不同特征进行统计分析, 其中单发息肉组及直径<0.5 cm息肉组的Hp阳性感染阳性率及血清G-17水平与对照组比较差异均无统计学意义 (P>0.05) ;而多发息肉组、直径为0.5~1.0 cm息肉组、直径>1.0 cm息肉组的Hp感染阳性率及G-17水平均显著高于对照组 (P<0.05) , 各组内比较血清G-17水平也均有显著差异 (P<0.05) ;以直肠息肉发生与否为自变量, 以血清G-17水平为因变量进行Spearman直线相关分析, 提示直肠息肉发生与血清G-17水平呈显著正相关 (r=0.30, P<0.01) 。[结论]Hp感染可通过血清G-17的协同作用增加直肠息肉发生的风险性, 建议对于Hp阳性患者应进行电子结肠镜检查, 对于检查发现息肉者应及时切除, 以免进一步恶化。
- 幽门螺杆菌 /
- 血清胃泌素-17 /
- 直肠息肉
Abstract: [Objective] To investigate the correlation between helicobacter pylori Hp infection, serum gastrin-17 (G-17) level and the occurrence of rectal polyps.[Methods]A retrospective analysis was performed on 1334 cases of electronic orthotopic colonoscopy personnel in our center from June 2017 to June 2018, which were divided into the polyp group (253 cases) and the control group (1081 cases) . All the selected groups were tested by C¹³ (13 C-UBT) breath test, and positive Hp infection was determined if the baseline value was greater than 4.0. The level of G-17 in fasting serum was quantitatively determined by ELISA. [Results]The positive rate of Hp infection and serum g-17 level in the rectum polyp group were significantly higher than those in the control group (P<0.01) . The serum G-17 level in the two groups was significantly higher than that in the two groups (P<0.01) . According to the statistical analysis in different characteristics of polyps, there was no significant difference in the positive rate of Hp infection and serum G-17 level between the single polyp group and the polyp group with diameter less than 0.5 cm and the control group (P>0.05) . The positive rate of Hp infection and G-17 level in the multipe polyp group, the polyp group with a diameter of 0.5 cm to 1.0 cm, and the polyp group with a diameter greater than 1.0 cm were significantly higher than the control group (P<0.05) , and the serum G-17 level in each group was also significantly different (P<0.05) . Spearman linear correlation analysis was conducted with the occurrence of rectal polyps as the independent variable and the serum G-17 level as the dependent variable, indicating that the occurrence of rectal polyps was significantly positively correlated with the serum g-17 level (r=0.30, P<0.01) . [Conclusion]Hp infection can increase the risk of rectal polyps through the synergistic effect of serum G-17. It is suggested that electronic colonoscopy should be performed for all hp-positive patients, and timely resection should be performed for polyps detected in the examination to avoid further deterioration.
- Helicobacter pylori /
- serum gastrin-17 /
- rectal polyp

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参考文献(19)

[1]	阮玉凤, 万霜, 孙璟, 等.幽门螺杆菌感染与结直肠息肉发生的关系[J].国际消化杂志, 2014, 34 (5):344-347.
[2]	温丽娜, 刘磊.3733例健康体检者胃幽门螺杆菌检测结果分析[J].国际检验医学杂志, 2016, 37 (12):3465-3466.
[3]	张航, 王琼, 张婷.幽门螺杆菌检测在胃癌诊断中的临床意义[J].中国中西医结合消化杂志, 2017, 25 (2):135-138.
[4]	郑荣娟, 胡爱萍, 李海英, 等.结肠息肉、结肠癌患者Hp感染与血浆G-17及环氧合酶-2的相关性[J].天津医药, 2012, 44 (7):734-735.
[5]	胡林, 王建新.幽门螺杆菌感染与结肠息肉相关性研究[J].现代医药卫生, 2017, 24 (12):3776-3778.
[6]	Abbass K, Gul W, Markert R, et al.Associasion of Helicobacter pylori infection with the development of colorectal polyps and colorectal Carcinoma[J].South Med J., 2011, 104 (7):473-476.
[7]	邓银香, 商洪涛, 舒鹏.转移性大肠癌的内科治疗进展[J].中国中西医结合消化杂志, 2015, 23 (3):221-224.
[8]	葛均波, 徐永健.内科学[M].北京:人民卫生出版社, 2013:394-397.
[9]	李艳萍, 李骥, 盖小荣, 等.结直肠息肉发病危险因素分析[J].首都医科大学学报, 2013, 34 (5):684-688.
[10]	中华医学会消化病学会幽门螺杆菌和消化性溃疡组.第五次全国幽门螺杆菌感染处理共识报告[J].中华消化杂志, 2017, 37 (6):346-378.
[11]	Hong SN, Lee SM, Kim JH, et al.Helicobacter pylori infection increases the risk of colorectal adenomas:crosssectional study and meta-anaylsis\[J\].Dig Dis Sci, 2012, 57:2184-2194.
[12]	唐斌, 张俊, 唐友攀, 等.幽门螺杆菌感染与结肠腺瘤性息肉的相关性研究[J].中国循证医学杂志, 2016, 16 (5):513-516.
[13]	丁慧, 戈之铮, 房静远.410例患者结直肠腺瘤与幽门螺杆菌感染特征及相关性分析[J].中华消化内镜杂志, 2018, 35 (7):507-509.
[14]	朱春平, 赵建业, 钱维, 等.不同Hp感染状态下血清胃泌素-17对胃窦萎缩的诊断价值[J].胃肠病学杂志, 2017, 22 (5):282-286.
[15]	张慧, 张苗, 郭瑞芳.结肠炎、结肠息肉及结肠癌患者Hp感染与血清G-17的相关性研究[J].内蒙古医学杂志, 2017, 49 (1):40-42.
[16]	孙颖, 李诺, 温艳惠, 等.幽门螺杆菌感染与结肠息肉相关性研究[J].中国实险诊断, 2018, 35 (7):573-575.
[17]	Churca E, Lanas A, Piazuelo E.Role of gastrin-peptides in Barrett's and colorectal carcinogenesis[J].Word J Gastroenterol, 2012, 18 (45):6560-6570.
[18]	Chen E, Liu M, Liu X.COX-2 Regulates E-cadherin expression through the NF-ΚB/snail signaling pathway in gastric caner[J].Int J Mol Med, 2013, 32 (1):93-100.
[19]	祖浩妍, 杨卓, 蒋会勇, 等.大肠息肉, 大肠癌幽门螺杆菌感染与中医证型的相关性研究[J].中国中西医结合消化杂志, 2016, 24 (5):347-350.