探讨消化性溃疡患者CD4⁺T淋巴细胞亚群、微小RNA-26a（miR-26a）和肿瘤坏死因子α（TNF-α）水平与幽门螺杆菌（HP）感染的关系。

回顾性收集2021年5月至2024年5月西安市国际医学中心医院收治的消化性溃疡患者中选取162例作为研究对象，其中HP阴性（45例）、Ⅰ型HP阳性（61例）、Ⅱ型HP阳性（56例），对比各组临床指标以及不同分型HP阳性患者血清CD4⁺T细胞、miR-26a、TNF-α水平，采用Spearman相关性分析HP感染类型与CD4⁺T细胞、TNF-α水平的关系。

HP阴性组、HP阳性组溃疡部位、Frorrest分级差异无统计学意义（P>0.05），HP阳性组溃疡平均直径、格拉斯哥-布拉奇福德（GBS）评分均大于HP阴性（P<0.05）；Ⅰ型、Ⅱ型HP阳性组患者溃疡部位单位、Frorrest分级单位比较差异无统计学意义（P>0.05），Ⅰ型组溃疡平均直径、GBS评分均大于Ⅱ型组（P<0.05）；HP阳性组TNF-α、CD4⁺T细胞水平均高于HP阴性组（P<0.05），两组miR-26a表达水平对比差异无统计学意义（P>0.05）；Ⅰ型HP阳性组TNF-α、CD4⁺T细胞水平均高于Ⅱ型组（P<0.05），两组miR-26 a表达水平对比差异无统计学意义（P>0.05）。Spearman相关性分析显示，消化性溃疡HP感染类型（Ⅰ型=1、Ⅱ型=0）与CD4⁺T细胞、TNF-α水平呈正相关（r=0.542、0.587，P<0.05）。

Ⅰ型HP感染患者与消化性溃疡患者更高水平CD4⁺T细胞、TNF-α水平有关，监测这些指标的变化，有助于识别可能由高毒力感染引发的强免疫炎症状态，从而对患者进行更有针对性的分层管理。

To investigate the relationship between serum levels of CD4⁺T lymphocyte subsets, microRNA-26a (miR-26a), and tumor necrosis factor-α (TNF-α) and Helicobacter pylori (Hp) infection in patients with peptic ulcers.

A total of 162 patients with peptic ulcers admitted to Xi'an International Medical Center Hospital from May 2021 to May 2024 were selected as the research subjects, including 45 cases who were Hp negative, 61 cases who were typeⅠ Hp positive, and 56 cases who were typeⅡ Hp positive. Clinical indicators of different groups and serum levels of CD4⁺T cells, miR-26a, and TNF-α in different subtypes of Hp positive patients were compared. Spearman correlation analysis was used to investigate the relationship between the types of Hp infection and the levels of CD4⁺T cells and TNF-α.

There was no statistically significant difference in ulcer location or Frorrest grading between the Hp negative and Hp positive groups (P>0.05). The average diameter and GBS score of ulcers in the Hp positive group were greater than those in the Hp negative group (P<0.05). There was no statistically significant difference in ulcer location or Frorrest grading between typeⅠ and typeⅡ Hp positive patients (P>0.05). The average diameter and GBS score of type Ⅰ ulcers were larger than those of typeⅡ ulcers (P<0.05). The levels of TNF-α and CD4⁺T cells in Hp positive patients were higher than those in Hp negative patients (P<0.05), and there was no statistically significant difference in miR-26a expression level between the two groups (P>0.05). The levels of TNF-α and CD4⁺T cells in typeⅠ Hp positive patients were higher than those in typeⅡ Hp positive patients (P<0.05), and there was no statistically significant difference in miR-26a expression level between the two groups (P>0.05). Spearman correlation analysis showed that the type of Hp infection in peptic ulcer (typeⅠ=1, typeⅡ=0) was positively correlated with the levels of CD4⁺T cells and TNF-α (r=0.542, 0.587, P<0.05).

TypeⅠ Hp infection and peptic ulcer are associated with higher levels of CD4⁺T cells and TNF-α. Monitoring changes in these indicators is conducive to identifying severe immunoinflammatory response potentially triggered by high-virulence infection, thus enabling more targeted stratification and management of patients.