Hp相关上消化道疾病中生长激素调素水平的临床意义  

The Clinical Significance of Ghrelin Level in Hp Related Upper Gastrointestinal Diseases

作　　者：张颖[1] 齐凤祥[1] 张志广[1] 江勇[1] 

机构地区：[1]天津医科大学第二医院消化科,300211

出　　处：《天津医药》2013年第8期766-768,共3页Tianjin Medical Journal

摘　　要：目的探讨根除Hp治疗对生长激素调素(ghrelin)水平的影响及其临床意义。方法选取慢性浅表性胃炎(CSG)40例,慢性萎缩性胃炎(CAG)42例,消化性溃疡(PU)41例,胃腺癌(CA)17例,均为Hp阳性。Hp阴性正常对照组40例。仅对CAG、CSG及PU组行Hp根除治疗,应用酶联免疫法测定3组在Hp根除前后血清ghrelin和胃蛋白酶原(PG)的水平,分析PG与ghrelin的相关性。应用RT-PCR方法检测胃黏膜ghrelin的表达水平。结果与对照组(30.41±8.97)相比,PU组(35.42±9.87)ghrelin水平升高;CAG组(18.59±8.19)和CA组(18.33±6.88)ghrelin水平降低;而CSG组(26.08±9.14)与对照组差异无统计学意义。Hp根除后,CSG组的血清和胃黏膜的ghrelin水平均升高(P<0.01);PU组的血清和胃黏膜的ghrelin水平均下降(P<0.01),而CAG组无明显变化(P>0.05)。CSG、CAG和CA3组患者血清PGⅠ/PGⅡ比值和ghrelin水平呈正相关(r=0.668,P<0.01)。结论根除Hp治疗可以影响上消化道疾病患者的ghrelin水平,ghrelin水平和PGⅠ/PGⅡ相关。ghrelin可作为Hp相关上消化道疾病诊断和预后评估的检测指标之一。Objective To investigate the impact and clinical significance of helicobacter pylori （Hp） elimination on ghrelin, Methods Forty patients with chronic superficial gastritis （CSG）, 42 patients with chronic atrophic gastritis （CAG）, 41 patients with peptic ulcer （PU） and 17 patients with gastric adenocarcinoma （CA） were included in this study. All of pa- tients in four groups were Hp-positive. Forty patients with Hp-negative were used as control. The Hp elimination were only performed in CAG, CSG and PU groups. The serum ghrelin and pepsinogen （PG） levels before and after Hp elimination were detected with ELISA assay in CSG, CAG and PU groups. The correlation between PG and glrelin was also detected. The ex- pression of ghrelin in gastric mucosa was detected by RT-PCR. Results Comparing with control group （30.41±8.97）, the ghrelin level was increased in PU group （35.42±9.87）, but which were decreased in CAG group （18.59±8.19） and CA group （18.33±6.88）. There was no significant difference in ghrelin level between CSG group （26.08±9.14） and control group. After Hp elimination, the serum and gastric mucosa ghrelin levels were significantly increased in CSG group （P 〈 0.01）, but both serum and gastric mucosa ghrelin levels were significantly decreased in PU group （P 〈 0.01）. And no significant difference in the level of ghrelin after Hp elimination in CAG group （P 〉 0.05）. A positive correlation was found between serum PG I/PG ]I and serum ghrelin level in CSG, CAG and CA groups （r=0.66g, P 〈 0.01）. Conclusion Hp elimination has an impact on ghrelin level in patients with upper gastrointestinal diseases, The changes of ghrelin level related to PG I/PG Ⅱ. Ghrelin can be used as one of the indexes of diagnostic and prognostic evaluation in Hp related upper gastrointestinal diseases.

关 键 词：螺杆菌 幽门 生长激素释放激素 胃炎 萎缩性 消化性溃疡 胃肿瘤 腺癌 胃蛋白酶原A 胃蛋白酶原C 

分 类 号：R573[医药卫生—消化系统]