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.