Effects of quadruple therapy on Hp clearance rate, gastrointestinal hormone levels and immune function in children with Hp infection and peptic ulcer
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摘要: 目的 探讨四联疗法治疗幽门螺杆菌(Hp)感染合并消化性溃疡(PU)患儿对Hp清除率、胃肠激素水平及免疫功能影响。方法 选择2020年1月—2021年10月来我院就诊的PU合并Hp感染患儿86例,按照随机数表法,分成观察组(n=43)和对照组(n=43)。对照组采用三联疗法治疗,观察组采用四联疗法治疗。比较治疗后2组的临床疗效、Hp清除率,记录2组主要症状改善时间,比较治疗前、后2组的胃肠激素[血浆胃泌素(GAS)、胃动素(MTL)、肾上腺髓质素(AM)、生长抑素(SS)、降钙素基因相关肽(CGRP)]、免疫功能[CD3+、CD4+、CD4+/CD8+]水平。结果 治疗后,观察组患儿的临床总有效率为93.02%,高于对照组的74.42%;治疗后,观察组的Hp清除率为88.37%,高于对照组的67.44%(P< 0.05);观察组的上腹疼痛、反酸、腹胀改善时间明显短于对照组(P< 0.05);治疗后,2组患儿的GAS、MTL、AM水平均低于治疗前,且观察组低于对照组(P< 0.05),2组患儿的SS、CGRP、CD3+、CD4+、CD4+/CD8+水平均高于治疗前,且观察组均高于对照组(P< 0.05);治疗期间,2组不良反应发生率差异无统计学意义(P>0.05)。结论 四联疗法治疗合并Hp感染PU患儿具有较好疗效,能够有效根除Hp,改善患儿胃肠功能,加强其免疫功能,且具有一定安全性。Abstract: Objective To explore the effects of quadruple therapy onHelicobacter pylori(Hp) clearance rate, the levels of gastrointestinal hormones and immune function in children with Hp infection and peptic ulcer(PU).Methods A total of 86 children with PU and Hp infection treated in the hospital were enrolled from January 2020 to October 2021. They were divided into observation group(n=43) and control group(n=43) by random number table method. The control group was treated with triple therapy, while observation group was treated with quadruple therapy. The clinical curative effect and Hp clearance rate after treatment were compared between the two groups. The improvement time of main symptoms in both groups was recorded. The levels of gastrointestinal hormones(plasma gastrin[GAS], motilin[MTL], adrenomedullin[AM], somatostatin[SS], calcitonin gene-related peptide[CGRP]) and immune function(CD3+, CD4+, CD4+/CD8+) before and after treatment were compared between the two groups.Results After treatment, total clinical response rate in observation group was higher than that in control group(93.02% vs. 74.42%)(P< 0.05). After treatment, Hp clearance rate in observation group was higher than that in control group(88.37% vs. 67.44%)(P< 0.05). The improvement time of upper abdominal pain, acid reflux and abdominal distension in observation group was significantly shorter than that in control group(P< 0.05). After treatment, levels of GAS, MTL and AM in both groups were decreased, which were lower in observation group than control group(P< 0.05). After treatment, levels of SS, CGRP, CD3+, CD4+and CD4+/CD8+in both groups were increased, which were higher in observation group than control group(P< 0.05). During treatment, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The curative effect of quadruple therapy is good for children with Hp infection and PU. It can effectively eradicate Hp, improve gastrointestinal function and enhance immune function, with certain safety.
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Key words:
- quadruple therapy /
- peptic ulcer /
- Hp infection /
- Hp clearance rate /
- gastrointestinal hormone /
- immune function
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表 1 2组临床疗效比较
例 组别 例数 痊愈 好转 无效 总有效率/% 观察组 43 27 13 3 93.021) 对照组 43 20 12 11 74.42 与对照组比较,1)P < 0.05。 表 2 2组Hp清除率比较
例 组别 例数 Hp阳性 Hp阴性 Hp清除率/% 观察组 43 5 38 88.371) 对照组 43 14 29 67.44 与对照组比较,1)P < 0.05。 表 3 2组主要症状改善时间比较
d,X±S 组别 例数 上腹疼痛 反酸 腹胀 观察组 43 3.56±0.841) 5.23±1.261) 2.05±0.611) 对照组 43 4.93±1.05 6.72±1.51 3.83±0.94 与对照组比较,1)P < 0.05。 表 4 2组胃肠激素水平比较
pg/mL,X±S 组别 例数 时间 GAS MTL AM SS CGRP 观察组 43 治疗前 129.06±27.11 520.23±43.24 113.08±21.34 7.53±1.48 3.27±0.75 治疗后 54.29±14.061)2) 316.51±31.271)2) 44.39±10.511)2) 12.11±1.641)2) 16.52±1.491)2) 对照组 43 治疗前 129.41±27.35 519.48±42.33 112.56±21.03 7.69±1.07 3.58±0.86 治疗后 76.24±15.021) 376.17±35.451) 60.74±14.621) 10.52±1.391) 10.93±1.041) 与同组治疗前比较,1)P < 0.05;与对照组比较,2)P < 0.05。 表 5 2组免疫功能比较
X±S 组别 例数 时间 CD3+/% CD4+/% CD4+/CD8+ 观察组 43 治疗前 48.14±5.09 28.43±2.31 0.97±0.22 治疗后 61.83±6.741)2) 39.22±3.451)2) 1.51±0.361)2) 对照组 43 治疗前 48.96±5.13 27.84±2.67 0.95±0.24 治疗后 52.15±6.771) 32.14±3.521) 1.28±0.311) 与同组治疗前比较,1)P < 0.05;与对照组比较,2)P < 0.05。 表 6 2组不良反应情况比较
例 组别 例数 恶心 胃肠道反应 腹胀 皮疹 不良反应发生率/% 观察组 43 2 1 2 1 13.95 对照组 43 3 2 1 1 16.28 -
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