辽宁庄河地区居民血清胃蛋白酶原含量检测分析  

Serum pepsinogenⅠandⅡin residents from Zhuanghe county in North China

作　　者：孙丽萍[1] 宫月华[1] 王兰[1] 董明[1] 袁媛[1] 

机构地区：[1]中国医科大学第一附属医院肿瘤研究所,沈阳110001

出　　处：《中华消化杂志》2006年第10期649-652,共4页Chinese Journal of Digestion

基　　金：国家"十五"科技攻关资助项目[2001BA703806-B);2004BA703B04-2]

摘　　要：目的检测辽宁庄河居民血清胃蛋白酶原(PG)含量,以明确其基本人群分布特征,并探讨相关影响因素。方法利用酶联免疫吸附试验(ELISA)方法对辽宁庄河地区6990名居民进行血清PGⅠ、PGⅡ含量检测,并计算PGⅠ/Ⅱ比值；利用胃镜及胃黏膜组织病理学检查进行胃疾病诊断；利用ELISA法检测血清幽门螺杆菌(Hp)IgG抗体滴度。结果辽宁庄河地区居民血清PGⅠ、PGⅡ及PGⅠ/Ⅱ中位值分别为86．9μg/L、10．6μg/L和8．1。男性血清PGⅠ、PGⅡ(95．2μg/L、12．1μg/L)显著高于女性(79．7μg/L、9．4μg/L；P=0．000),PGⅠ/Ⅱ(7．9)显著低于后者(8．3,P=0．000)。PGⅠ/Ⅱ随年龄增高呈阶段性显著降低。PGⅠ/Ⅱ在胃黏膜由基本正常(10．4)向非萎缩性病变(8．8)、萎缩性病变(6．6)转变过程中呈显著性降低。Hp感染者血清PGⅠ、PGⅡ(88．7μg/L,11．4μg/L)显著高于非感染者(81．4μg/L,8．4μg/L；P=0．000),PGⅠ/Ⅱ(7．7)显著低于后者(9．6,P=0．000)。以PGⅠ/Ⅱ为指标筛选胃黏膜萎缩性病变,ROC曲线下面积为0．622,最适临界值为6．9,灵敏度53．2％,特异度67．5％。多因素Logistic回归分析,男性(OR：1．151,95％CI：1．042～1．272,P=0．006)、年龄≥61岁(OR：1．358,95％CI：1．188～1．553,P=0．000)、萎缩性病变(OR：2．075,95％CI：1．870～2．302,P=0．000)及Hp感染(OR：1．546,95％CI：1．368～1．748,P=0．000)是明显影响PGⅠ/Ⅱ水平的因素。结论辽宁庄河居民血清PG水平呈明显偏态分布,受性别、年龄因素影响,与胃疾病和Hp感染密切相关。PGⅠ/Ⅱ较之PGⅠ和PGⅡ,更适用于胃疾病筛查。Objective To determine the serum level of pepsinogen Ⅰ ,Ⅱ （PGⅠ , PGⅡ） and PGⅠ/Ⅱ in the residents from Zhuanghe county, a high risk area of gastric cancer in North China, and to explore their distribution as well as related factors. Methods Serum PG Ⅰ and PGⅡ levels were detected with ELISA method in 6990 subjects. Gastric diseases were diagnosed by endoscopy and histopatho logic examination. Serum H. pylori-IgG antibody was determined by ELISA method. Results The median values for PGⅠ, PGⅡ , PGⅠ /Ⅱ were 86.9 μg/L, 10.6μg/L and 8.1 respectively. Serum PG Ⅰ and PGⅡ in male（95.2 μg/L, 12. 1μg/L） were significantly higher than those in female（79.7μg/L, 9.4 μg/L; P=0. 000）, PG Ⅰ /Ⅱ ratio（7.9） was significantly lower in male （8.3, P = 0. 000）. There were significantly decrease in PG Ⅰ /Ⅱ ratio along with age increase. PGⅠ /Ⅱ ratio decreased significantly following with progression of gastric mucosa from normal （10.4） to non atrophic lesions（8.8） and to atrophic lesions （6.6）. Serum PG Ⅰ and PG Ⅱ in H. pylori positive subjects （88. 7μg/L, 11. 4μg/L） were significantly higher than those in H. pylori negative subjects （81.4μg/L, 8.4μg/L; P = 0. 000）, PGⅠ /Ⅱ ratio（7.7） was significantly lower in H. pylori positive subjects （9.6, P = 0. 000）. For patients with atrophic lesions, the area under the PG Ⅰ /Ⅱ ROC curve was 0. 622. The best cut-offpoint for PG Ⅰ / Ⅱ was 6.9, with sensitivity of 53.2%, and specificity of 67.5%. Factors linked to PG Ⅰ /Ⅱ were identified using multinomial logistic regression： male （OR： 1. 151, 95% CI： 1. 042-1. 272, P = 0. 006）, age=61（OR： 1. 358, 95% CI： 1. 188-1. 553, P = 0. 000）, atrophic lesion（OR： 2.075, 95% CI： 1. 870-2. 302, P = 0.000）, and H. pylori infection （OR： 1. 546, 95% CI： 1. 368-1. 748, P = 0. 000）. Conclusions The serum PG levels are significantly skewed from normal distrubition in the residents of Zhuanghe county, and affected by ag

关 键 词：胃蛋白酶原 胃癌 幽门螺杆菌 筛查 

分 类 号：R735.2[医药卫生—肿瘤]