| Objective The purpose of this study was to investigate the situation of HP infection in patients with RA during the first diagnosis activity period,and compare it with the healthy control group to explore whether HP infection is related to the onset of RA;Compare the serological indexes of RA patients infected with HP to determine whether HP infection is related to the clinical symptoms and serological level of RA;Give standardized HP eradication treatment to patients with HP positive RA,explore whether HP eradication has positive significance for the remission of RA patients,and provide ideas for RA patients to reduce symptoms,maintain remission,prevent recurrence and improve prognosis in clinical treatment.Methods 105 outpatients or inpatients with active RA diagnosed for the first time in the Department of Rheumatology of the Affiliated Hospital of Inner Mongolia Medical University from December 2020 to December 2021 were selected as the research objects.132 cases in the healthy control group in the physical examination center of our hospital were selected.All subjects were given 14C breath test to detect whether they were infected with HP and compare the infection rate between them;According to the results of 14C breath test,after matching the DAS-28 score,RA patients were randomly divided into Anti HP group and control group.The patients in the anti HP group were given a two-week quadruple eradication regimen:rabeprazole,bismuth potassium citrate,clarithromycin and amoxicillin.The breath test was rechecked after 3 months.The DAS-28 score,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and tumor necrosis factor were compared before and 3 months after treatment-α(TNF-α)、Levels of anti cyclic citrullinated peptide antibody-Ⅱ(CCP-Ⅱ),anti mutant citrulline vimentin antibody(MCV),interleukin-6(IL-6),interleukin-10(IL-10),rheumatoid factor immunoglobulin A(IGA),rheumatoid factor immunoglobulin G(IgG)and rheumatoid factor immunoglobulin M(IgM).Results the infection rate of HP in RA patients was 65.71%and that in healthy people was 29.32%,P<0.05.Before HP eradication treatment,the DAS-28 scores of anti HP group and control group were significantly higher than those of HP negative group(P<0.05).The ESR and CCP-Ⅱ of control group were significantly higher than those of HP negative group(P<0.05),but there was no significant difference between HP negative group and eradication group.Other indexes such as CRP and TNF in anti HP group and control group-a、There was no significant difference in the levels of MCV,IL-6,IL-10,rheumatoid factor IgA,rheumatoid factor IgG and Rheumatoid Factor IgM compared with HP negative group(P>0.05).In the anti HP group,14C breath test was rechecked after treatment,and eradication failed in 2 patients,with an eradication rate of 94.28%.After 3 months of treatment,the levels of DAS-28,CRP,ESR and TNF in anti HP group and control group,HP(-)group and control group were compared-α、CCP-Ⅱ and IL-6,P<0.05,the difference was statistically significant.There was significant difference in rheumatoid factor IgA between anti HP group and control group,but there was no significant difference in rheumatoid factor IgA between HP(-)group and control group.There was significant difference in Rheumatoid Factor IgM between the control group and HP(-)group(P<0.05),but there was no significant difference in MCV,IL-10 and rheumatoid factor IgG between anti HP group and control group,HP(-)group and control group(P>0.05).Result The infection rate of HP was 65.71%in RA patients and 29.32%in healthy people.There was significant difference between them(P<0.05).Before HP eradication treatment,the DAS-28 score of RA patients in HP positive group was significantly higher than that in HP negative group(P<0.05).There were significant differences in ESR and CCP-Ⅱbetween control group and HP negative group(P<0.05)-α、There was no significant difference in MCV,IL-6,IL-10,rheumatoid factor IgA,rheumatoid factor IgG and Rheumatoid Factor IgM;After 3 months of treatment,the DAS-28 score and the main serological indexes CRP,ESR and TNF in the anti HP group were compared with those in the control group-α、The levels of CCP-Ⅱ,IL-6 and rheumatoid factor IgA were significantly improved(P<0.05),but there was no significant difference in the levels of MCV,IL-10,rheumatoid factor IgG and Rheumatoid Factor IgM.Conclusion The rate of HP infection in RA patients was higher than that in healthy control group.The DAS-28 score of RA patients in HP positive group was significantly higher than that in negative group;Three months after eradication of HP,DAS-28 score,ESR,CRP and TNF in anti HP group-α、The levels of CCP-Ⅱ,MCV,IL-10 and rheumatoid factor IgA in the control group were significantly improved compared with those in the control group.Therefore,infection with HP has an adverse effect on the condition of patients with rheumatoid arthritis.Eradicating HP can help patients with rheumatoid arthritis reduce symptoms,prevent recurrence,maintain remission and improve prognosis to a certain extent. |
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