十二指肠溃疡患者Hpylori根治前后NO、TNFa含量和NOS表达的变化及意义
冯丽英, 冯志杰, 姚希贤, 河北医科大学第二医院消化内科 河北省石家庄市 050000
项目负责人: 冯丽英, 050000, 河北省石家庄市, 河北医科大学第二医院消化内科. ffly513@sohu.com
电话: 0311-7222301
收稿日期: 2004-12-10 接受日期: 2005-01-26
摘要
目的: 观察H pylori 感染对十二指肠溃疡(DU)患者NOS、NO和TNFa的影响，探讨H.pylori感染、NO和TNFa在DU中的作用和意义.
, http://www.100md.com
方法:随机选择经电子胃镜和病理检查确诊的H pylori阳性DU患者60例，采用快速尿素酶试验、组织涂片Gram染色和Warthin-Starry银染色进行H pylori检测.用兰索拉唑+阿莫西林+克拉霉素治疗7 d，于H pylori根治前后检测血清NO、TNFa的含量、免疫组化法检测胃窦黏膜eNOS和iNOS蛋白的表达，并与内镜和病理检查证实胃黏膜大致正常H.pylori阴性的15名健康志愿者作对照观察.
结果: H pylori根治率为82.14%(46/56)，溃疡愈合率89.28%(50/56).正常人胃黏膜以eNOS表达为主、iNOS表达很少，NO、TNFa含量少，H pylori感染后胃黏膜eNOS、iNOS表达和NO、TNFa含量较正常对照增加(3 568.78±624.34，238.43±72.92与2 448.27±723.31，138.53±59.65;P<0.001)，iNOS表达更显著.H pylori根除后，eNOS、iNOS的表达以及NO和TNFa含量(2 908.74±717.58，142.43±58.63)均低于治疗前(P<0.001)，但iNOS和NO仍高于正常对照组(P<0.05).
, 百拇医药
结论: iNOS过度表达和NO、TNFa含量增加可能在消化性溃疡的发病机制中发挥一定作用，有可能是H pylori感染导致消化性溃疡的发病机制之一.NO在溃疡的愈合中也起一定作用.
冯丽英, 冯志杰, 姚希贤. 十二指肠溃疡患者H pylori根治前后NO、TNFa含量和NOS表达的变化及意义. 世界华人消化杂志 2005;13(5):695-697
Martin MJ, Jimenez MD, Motilva V. New issues about nitric oxide and its effects on the gastrointestinal tract.
Curr Pharm Des 2001;7:881-908
2 李子俊, 陈颜芳, 林秋雄, 王启仪, 刘婉薇, 符永恒, 詹德娟. 幽门螺杆菌阳性胃炎患者胃黏膜一氧化氮合酶
, http://www.100md.com
活力变化的意义. 中华消化内镜杂志 2000;17:175-177
3 Fischer H, Becker JC, Boknik P, Huber V, Luss H, Neumann J, Schmitz W, Domschke W, Stachura J, Konturek JW.
Expression of constitutive nitric oxide synthase in rat and human gastrointestinal tract. Biochim Biophy Acta
1999;1450:414-422
4 Kaise M, Miwa J, Iihara K, Suzuki N, Oda Y, Ohta Y. Helicobacter pylori stimulates inducible nitric oxide synthase in
, 百拇医药
diverse topographical patterns in various gastroduodenal disorders. Dig Dis Sci 2003;48:636-643
5 Zhang X, Ruiz B, Correa P, Miller MJ. Cellular dissociation of NF-kappaB and inducible nitric oxide synthase in
Helicobacter pylori infection. Free Radic Biol Med 2000;29:730-735
6 王德荣, 陈健, 李君曼, 张振国. 慢性胃炎及消化性溃疡诱生型一氧化氮合酶表达和Hp感染的意义.
华人消化杂志 1998;6:597-599
, 百拇医药
7 Lamarque D, Kiss J, Tankovic J, Flejou JF, Delchier JC, Whittle BJ. Induction of nitric oxide synthase in vivo and cell
injury in rat duodenal epithelium by a water soluble extract of Helicobacter pylori. Br J Pharmacol 1998;123:1073-1078
8 曾锦章, 张万岱, 刘晓霞, 张振书, 张亚历, 周殿元. 蛋白酪氨酸激酶与一氧化氮合酶活性的变化在
胃黏膜损伤修复中的作用和意义. 世界华人消化杂志 2000;8:354-355
9 Tatemichi M, Ogura T, Sakurazawa N, Nagata H, Sugita M, Esumi H.Roles of inducible nitric oxide synthase in
, http://www.100md.com
the development and healing ofexperimentally induced gastric ulcers. Int J Exp Pathol 2003;84:213-220
10 Schwentker A, Billiar TR. Nitric oxide and wound repair. SurgClin North Am 2003;83:521-530
11 Mehmet N, Refik M, Harputluoglu M, Ersoy Y, Aydin NE, Yildirim B.Serum and gastric fluid levels of cytokines and
nitrates in gastric diseasesinfected with Helicobacter pylori. New Microbiol 2004;27:139-148
, http://www.100md.com
12 Klausz G, Tiszai A, Tiszlavicz L, Gyulai Z, Lenart Z, Lonovics J,Mandi Y. Local and peripheral cytokine response
and CagA status of Helicobacterpylori-positive patients with duodenal ulcer. Eur Cytokine Netw 2003;14:143-148
13 张国安, 刘小朋, 张信, 施水兰, 陈紫榕. 肿瘤坏死因子对幽门螺杆菌感染者胃泌素产生的影响.
中国人兽共患病杂志 2000;16:68-69
14 Takeuchi T, Miura S, Wang L, Uehara K, Mizumori M, Kishikawa H,Hokari R, Higuchi H, Adachi M, Nakamizo H,Ishii H. Nuclear factor-kappaBand TNF-alpha mediate gastric ulceration induced by phorbol myristateacetate.
, http://www.100md.com
Dig Dis Sci 2002;47:2070-2078
15 Hopman WP, de Jong DJ, Naber AH, Jansen JB. Tumour necrosis factoralpha antibody affects gastrin release in
Crohn disease. Scand JGastroenterol 2003;38:522-525
16 Beales IL. Monoclonal antibody to tumor necrosis factor-alphareduces hypergastrinemia in
Helicobacter pylori infection. AmJ Med 2001;111:77-78
编辑 张海宁, http://www.100md.com( 冯丽英,冯志杰, 姚希贤)
项目负责人: 冯丽英, 050000, 河北省石家庄市, 河北医科大学第二医院消化内科. ffly513@sohu.com
电话: 0311-7222301
收稿日期: 2004-12-10 接受日期: 2005-01-26
摘要
目的: 观察H pylori 感染对十二指肠溃疡(DU)患者NOS、NO和TNFa的影响，探讨H.pylori感染、NO和TNFa在DU中的作用和意义.
, http://www.100md.com
方法:随机选择经电子胃镜和病理检查确诊的H pylori阳性DU患者60例，采用快速尿素酶试验、组织涂片Gram染色和Warthin-Starry银染色进行H pylori检测.用兰索拉唑+阿莫西林+克拉霉素治疗7 d，于H pylori根治前后检测血清NO、TNFa的含量、免疫组化法检测胃窦黏膜eNOS和iNOS蛋白的表达，并与内镜和病理检查证实胃黏膜大致正常H.pylori阴性的15名健康志愿者作对照观察.
结果: H pylori根治率为82.14%(46/56)，溃疡愈合率89.28%(50/56).正常人胃黏膜以eNOS表达为主、iNOS表达很少，NO、TNFa含量少，H pylori感染后胃黏膜eNOS、iNOS表达和NO、TNFa含量较正常对照增加(3 568.78±624.34，238.43±72.92与2 448.27±723.31，138.53±59.65;P<0.001)，iNOS表达更显著.H pylori根除后，eNOS、iNOS的表达以及NO和TNFa含量(2 908.74±717.58，142.43±58.63)均低于治疗前(P<0.001)，但iNOS和NO仍高于正常对照组(P<0.05).
, 百拇医药
结论: iNOS过度表达和NO、TNFa含量增加可能在消化性溃疡的发病机制中发挥一定作用，有可能是H pylori感染导致消化性溃疡的发病机制之一.NO在溃疡的愈合中也起一定作用.
冯丽英, 冯志杰, 姚希贤. 十二指肠溃疡患者H pylori根治前后NO、TNFa含量和NOS表达的变化及意义. 世界华人消化杂志 2005;13(5):695-697
Martin MJ, Jimenez MD, Motilva V. New issues about nitric oxide and its effects on the gastrointestinal tract.
Curr Pharm Des 2001;7:881-908
2 李子俊, 陈颜芳, 林秋雄, 王启仪, 刘婉薇, 符永恒, 詹德娟. 幽门螺杆菌阳性胃炎患者胃黏膜一氧化氮合酶
, http://www.100md.com
活力变化的意义. 中华消化内镜杂志 2000;17:175-177
3 Fischer H, Becker JC, Boknik P, Huber V, Luss H, Neumann J, Schmitz W, Domschke W, Stachura J, Konturek JW.
Expression of constitutive nitric oxide synthase in rat and human gastrointestinal tract. Biochim Biophy Acta
1999;1450:414-422
4 Kaise M, Miwa J, Iihara K, Suzuki N, Oda Y, Ohta Y. Helicobacter pylori stimulates inducible nitric oxide synthase in
, 百拇医药
diverse topographical patterns in various gastroduodenal disorders. Dig Dis Sci 2003;48:636-643
5 Zhang X, Ruiz B, Correa P, Miller MJ. Cellular dissociation of NF-kappaB and inducible nitric oxide synthase in
Helicobacter pylori infection. Free Radic Biol Med 2000;29:730-735
6 王德荣, 陈健, 李君曼, 张振国. 慢性胃炎及消化性溃疡诱生型一氧化氮合酶表达和Hp感染的意义.
华人消化杂志 1998;6:597-599
, 百拇医药
7 Lamarque D, Kiss J, Tankovic J, Flejou JF, Delchier JC, Whittle BJ. Induction of nitric oxide synthase in vivo and cell
injury in rat duodenal epithelium by a water soluble extract of Helicobacter pylori. Br J Pharmacol 1998;123:1073-1078
8 曾锦章, 张万岱, 刘晓霞, 张振书, 张亚历, 周殿元. 蛋白酪氨酸激酶与一氧化氮合酶活性的变化在
胃黏膜损伤修复中的作用和意义. 世界华人消化杂志 2000;8:354-355
9 Tatemichi M, Ogura T, Sakurazawa N, Nagata H, Sugita M, Esumi H.Roles of inducible nitric oxide synthase in
, http://www.100md.com
the development and healing ofexperimentally induced gastric ulcers. Int J Exp Pathol 2003;84:213-220
10 Schwentker A, Billiar TR. Nitric oxide and wound repair. SurgClin North Am 2003;83:521-530
11 Mehmet N, Refik M, Harputluoglu M, Ersoy Y, Aydin NE, Yildirim B.Serum and gastric fluid levels of cytokines and
nitrates in gastric diseasesinfected with Helicobacter pylori. New Microbiol 2004;27:139-148
, http://www.100md.com
12 Klausz G, Tiszai A, Tiszlavicz L, Gyulai Z, Lenart Z, Lonovics J,Mandi Y. Local and peripheral cytokine response
and CagA status of Helicobacterpylori-positive patients with duodenal ulcer. Eur Cytokine Netw 2003;14:143-148
13 张国安, 刘小朋, 张信, 施水兰, 陈紫榕. 肿瘤坏死因子对幽门螺杆菌感染者胃泌素产生的影响.
中国人兽共患病杂志 2000;16:68-69
14 Takeuchi T, Miura S, Wang L, Uehara K, Mizumori M, Kishikawa H,Hokari R, Higuchi H, Adachi M, Nakamizo H,Ishii H. Nuclear factor-kappaBand TNF-alpha mediate gastric ulceration induced by phorbol myristateacetate.
, http://www.100md.com
Dig Dis Sci 2002;47:2070-2078
15 Hopman WP, de Jong DJ, Naber AH, Jansen JB. Tumour necrosis factoralpha antibody affects gastrin release in
Crohn disease. Scand JGastroenterol 2003;38:522-525
16 Beales IL. Monoclonal antibody to tumor necrosis factor-alphareduces hypergastrinemia in
Helicobacter pylori infection. AmJ Med 2001;111:77-78
编辑 张海宁, http://www.100md.com( 冯丽英,冯志杰, 姚希贤)
