萎缩性胃炎患者外周血TLR4 MyD88 NF-κB及PG水平变化与Hp感染病变进程及炎症反应的关系

doi:10.3969/j.issn.1006-6233.2023.10.008

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摘要 目的:探讨萎缩性胃炎患者血清Toll样受体4(TLR4)、髓样分化因子-88(MyD88)、核因子κB(NF-κB)、胃蛋白酶原(PGⅠ、PGⅡ)的表达变化及其临床意义。方法:选取榆林市第一医院2020年12月至2023年3月期间经胃镜取病理学组织检查证实为萎缩性胃炎的患者98例作为A组、选取同期检查确诊的非萎缩性胃炎患者100例作为B组、健康体检志愿者100例作为C组,检查对比三组研究对象血清TLR4、MyD88、NF-κB、PGⅠ、PGⅡ、白细胞介素-6(IL-6)、IL-1β、肿瘤坏死因子-α(TNF-α)水平,并按照患者是否合并Hp感染、萎缩性胃炎内镜分级标准进行分层对比上述指标的差异。结果:A组患者的TLR4、MyD88、NF-κB、PGⅡ、IL-6、IL-1β、TNF-α显著高于B组、C组,PGⅠ测定值显著低于B组和C组,差异具有统计学意义(P<0.05);B组患者的TLR4、MyD88、NF-κB、PGⅡ、IL-6、IL-1β、TNF-α显著高于C组,PGⅠ测定值显著低于C组,差异具有统计学意义(P<0.05);Hp阳性组的TLR4、MyD88、PGⅡ、IL-6、IL-1β、TNF-α显著高于Hp阴性组,PGⅠ测定值显著低于Hp阴性组,差异具有统计学意义(P<0.05);Ⅲ级病变患者的TLR4、MyD88、NF-κB、PGⅡ、IL-6、IL-1β、TNF-α显著高于Ⅱ级、Ⅰ级患者,PGⅠ测定值显著低于Ⅱ级、Ⅰ级患者,差异具有统计学意义(P<0.05);Ⅱ级病变患者的TLR4、MyD88、NF-κB、PGⅡ、IL-6、IL-1β、TNF-α显著高于Ⅰ级患者,PGⅠ测定值显著低于Ⅰ级患者,差异具有统计学意义(P<0.05);TLR4、MyD88、NF-κB与IL-6、IL-1β、TNF-α均呈显著正相关关系(P<0.05),PGⅡ、PGⅠ与IL-6、IL-1β、TNF-α无明显的相关性(P>0.05).结论:TLR4/MyD88/NF-κB通路与萎缩性胃炎患者病变程度、发生Hp感染有关,并且在一定程度上调控患者炎症反应严重程度。

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关键词 ：萎缩性胃炎, Toll样受体4, 髓样分化因子-88, 核因子κB, 胃蛋白酶原

Abstract：Objective: To investigate the changes in the expression of serum Toll-like receptor 4 (TLR4), myeloid differentiation factor-88 (MyD88), nuclear factor κB (NF-κB), and pepsinogen (PG Ⅰ, PG Ⅱ) in patients with atrophic gastritis, and their clinical significance. Methods: A total of 98 patients with atrophic gastritis confirmed by gastroscopy taking pathological tissue examination during the period from December 2020 to March 2023 in the First Hospital of Yulin City were selected as Group A, 100 patients with non-atrophic gastritis confirmed by examination during the same period were selected as Group B, and 100 volunteers for health physical examination were selected as Group C. The serum of the study subjects of the three groups were examined and compared with those of the three groups in terms of the expression changes of serum TLR4, MyD88, NF- κB, PGⅠ, PGⅡ, interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α) levels of the three study groups, and stratified according to whether the patients were co-infected with Hp infection or not, and endoscopic grading criteria of atrophic gastritis for comparing the differences of the above indexes. Results: The TLR4, MyD88, NF-κB, PGII, IL-6, IL-1β, and TNF-α of patients in Group A were significantly higher than those in Groups B and C, and the PGⅠ assay was significantly lower than those in Groups B and C, with a statistically significant difference (P<0.05); the TLR4, MyD88, NF- κB, PGII, IL-6, IL-1β, and TNF-α were significantly higher than those in group B, and the values of PGⅠ assay were significantly lower than those in group C, and the difference was statistically significant (P<0.05); in the Hp-positive group, the values of TLR4, MyD88, PGII, IL-6, IL-1β, and TNF-α were significantly higher than those in the Hp-negative group, and the values of PGⅠ assay were significantly lower than those in the Hp-negative group, and the difference was statistically significant (P<0.05); TLR4, MyD88, NF-κB , PGⅡ, IL-6, IL-1β, and TNF-α of patients with grade III lesions were significantly higher than those of patients with grades II and I, and the values of PGⅠ assay were significantly lower than those of patients with grades II and I, and the difference was statistically significant (P<0.05); TLR4 of patients with grade II TLR4, MyD88, NF-κB , PGII, IL-6, IL-1β, TNF-α were significantly higher in patients with grade II lesions than in patients with grade I. The PGⅠ assay was significantly lower than that in patients with grade I, and the difference was statistically significant (P<0.05); TLR4, MyD88, NF-κB with IL-6, IL-1β, and TNF-α were all significantly positively correlated (P<0.05), and there was no significant correlation between PGII and PGⅠ and IL-6, IL-1β, and TNF-α (P>0.05). Conclusion: The TLR4/MyD88/NF-κB pathway is related to the degree of lesions and the occurrence of Hp infection in patients with atrophic gastritis, and regulates the severity of inflammatory response in patients to a certain extent.

Key words： Atrophic gastritis Toll like receptor 4 Medullary differentiation factor 88 Nuclear factor κB Pepsinogen

基金资助:陕西省重点研发计划项目,(编号:2020SF-105)

通讯作者: 杨金艳

引用本文:

李飞飞, 杨金艳, 韩瑞瑞, 穆亚娟, 高玲, 景慧, 钱丽鲜. 萎缩性胃炎患者外周血TLR4 MyD88 NF-κB及PG水平变化与Hp感染病变进程及炎症反应的关系[J]. 河北医学, 2023, 29(10): 1629-1634.
LI Feifei, YANG Jinyan, HAN Ruirui, et al. Relationship between Changes in Peripheral Blood TLR4 MyD88 NF-κB and PG Levels and Hp Infection Lesion Progression and Inflammatory Response in Patients with Atrophic Gastritis. HeBei Med, 2023, 29(10): 1629-1634.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.10.008 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I10/1629