Abstract: OBJECTIVE To explore the influence of Helicobacter pylori (Hp) infection on gallbladder mucosal lesions of the patients with calculous cholecystitis based on miR-21/PTEN/Akt signaling pathway. METHODS A total of 181 patients with calculous cholecystitis who were treated in Shengjing Hospital of China Medical University from Jan 2017 to Jan 2020 were enrolled in the study and were divided into the Hp infection group and the no Hp infection group according to the status of Hp infection of gallbladder tissue. The status of gallbladder mucosal lesions was compared between the two groups of patients, the activity of phospholipase A2 (PLA2) in gallbladder mucosa, expression level of cholecystokinin-A (CCK-A) receptor in gallbladder wall, gallbladder emptying rate and expression levels of microRNA (miRNA)-21/phosphatase and tensin hmmlogydeleted on ten (PTEN)/Akt signaling pathways were detected. RESULTS The positive rate of gallbladder metaplasia of the Hp infection group was higher than that of the no Hp infection group (P＜0.05). The activity of gallbladder mucosa PLA2 of the Hp infection group was higher than that of the no Hp infection group(P＜0.05). The expression level of CCK-A receptor mRNA in gallbladder wall and gallbladder emptying rate were lower in the Hp infection group than in the no Hp infection group (P＜0.05). The relative expression levels of miR-21 and Akt mRNA in gallbladder mucosa were higher in the Hp infection group than in the no Hp infection group (P＜0.05); the relative expression level of PTEN mRNA of the Hp infection group was lower than that of the no Hp infection group (P＜0.05). CONCLUSION KG-*2 The Hp infection is closely associated with the calculous cholecystitis, it can accelerate the lesions of gallbladder mucosa, and the mechanisms may be associated with the activation of miR-21/PTEN/Akt signaling pathways.