Interrelation secretory activity of stomach and immunes changes of peripheral blood when ulcerogenesis stomach.

L V Matveeva, L M Mosina
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Abstract

Incidence of gastric ulcer is high in almost all countries of the world. On the development and course of the disease affect the state acid- and enzymes production stomach, immune status. The purpose was to determine the presence and power of correlative links secretory activity of the stomach and immune changes in the peripheral blood during exacerbation of ulcer disease stomach.

Methods: Surveyed in obtaining informed consent 42 patients with gastric ulcer in the acute phase prior to the eradication and antisecretory therapy and 40 healthy volunteers. On the state of function acid- and enzymes production of the gastric mucosa judged by the results of a 2-hour intragastric pH-metry and serum concentration pepsinogen, gastrin before the start of active treatment. Immunophenotype lymphocytes on CD-antigens (CD3, CD4, CD8, CD16, CD19, CD45, CD56) was measured by immunofluorescence, levels immunoglobulin isotype M, G, A, E - ELISA method.

Results: When short-term intragastric pH-metry of the stomach hyperacidity patients recorded 6.7 times more likely than healthy, normacidity - 12.3 times less. Reduction of acid production was observed up to 8.6 times more, indicating the development of mucosal atrophy. Basal pH in the antrum was lower by 54.5% than in the control group, with stimulation increased by 33.6%, but remained lower than the values of healthy individuals by 48.7%. When ELISA amount pepsinogen patients showed significant increase in serum levels of PG-I relative to the control group at 33.4%, PG-II - 52%. In assessing the immune status of patients were identified changes in system phagocytes, cellular and humoral links, most pronounced for severe current peptic ulcer disease.

Conclusion: The results indicate the presence of positive and negative correlative links mild to moderate force between indicators of secretory activity of gastric mucosal innate and adaptive immunity in patients with acute exacerbation of peptic ulcer disease. The presence and nature of these relationships should be taken into account when appointing antisecretory drugs.

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胃溃疡发生时胃分泌活性与外周血免疫变化的关系。
胃溃疡的发病率在世界上几乎所有国家都很高。对疾病的发展和病程影响胃酸和酶的产生状态、免疫状态。目的是确定胃溃疡加重期间胃分泌活性和外周血免疫变化的相关联系的存在和力量。方法:对42例急性期胃溃疡患者和40名健康志愿者进行知情同意调查。积极治疗前2小时胃内ph测定及胃蛋白酶原、胃泌素的血药浓度判断胃粘膜功能、酸和酶的生成状态。采用免疫荧光法检测cd抗原上的免疫表型淋巴细胞(CD3、CD4、CD8、CD16、CD19、CD45、CD56),免疫球蛋白同型M、G、A、E的水平。结果:短期胃内ph值测定时,胃酸过高的患者发生胃酸升高的可能性是健康人的6.7倍,正常胃酸降低12.3倍。酸的产生减少高达8.6倍,表明粘膜萎缩的发展。与对照组相比,胃窦的基础pH值降低了54.5%,刺激增加了33.6%,但仍比健康个体低48.7%。ELISA测定胃蛋白酶原量时,患者血清PG-I水平较对照组显著升高33.4%,PG-II水平较对照组显著升高52%。在评估患者的免疫状态时,发现了系统吞噬细胞、细胞和体液联系的变化,最明显的是目前严重的消化性溃疡疾病。结论:研究结果提示消化性溃疡急性加重期患者胃黏膜分泌活性指标与固有免疫和适应性免疫指标之间存在轻度至中度的正相关和负相关关系。在指定抗分泌药物时,应考虑到这些关系的存在和性质。
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