肝硬化门脉高压性胃病血清胃蛋白酶原的变化及意义  

Changes in serum pepsinogen in patients with liver cirrhosis and portal hypertensive gastropathy

作　　者：毛华[1] 李瑞[1] 

机构地区：[1]南方医科大学珠江医院消化科,广东广州510282

出　　处：《南方医科大学学报》2014年第1期141-143,146,共4页Journal of Southern Medical University

基　　金：广东省科技厅科技计划项目(2009B030801212)

摘　　要：目的测定肝硬化者血清PG的水平,探讨肝硬化发生胃粘膜病变时胃粘膜的功能状态。方法胃镜观察已确诊的51例肝硬化患者胃粘膜病变,快速尿素酶实验或碳13呼气实验明确幽门螺杆菌感染情况,肝功能进行Child-Pugh分级,乳胶增强免疫比浊法检测血清PG(PGⅠ、PGⅡ)浓度,得出PGⅠ/PGⅡ值(PGR),数据进行统计学分析。结果血清PGⅠ水平比较,肝硬化PHG组明显低于无PHG组及对照组,差异有统计学意义,PGⅡ、PGR差异无统计学意义。肝硬化幽门螺杆菌感染与无幽门螺杆菌感染两组间比较PGⅡ、PGR比较有差异。肝硬化肝功能分级组间及酒精性肝硬化与乙肝肝硬化比较血清PG水平均无明显差异。结论肝硬化合并PHG时血清PGⅠ水平明显降低,胃粘膜损伤可达固有层,分泌功能降低;幽门螺杆菌可以影响PGⅡ水平;血清PG水平与肝功能无明显关系;血清PG水平尤其PGⅠ在一定程度上可以反映肝硬化胃粘膜功能状态。Objective To determine serum pepsinogen levels in patients with liver cirrhosis and investigate the functions of the gastric mucosa in these patients with concurrent portal hypertensive gastropathy （PHG）. Methods Fifty-one patients with liver cirrhosis and 22 healthy controls were studied by gastroscopy. The hepatic function of the patients with or without PHG were evaluated with Child-Pugh grade. Helicobacter pylori infection was detected using rapid urease test or exhalation of carbon 13. The serum pepsinogen I and II levels were tested by latex-enhanced immunoturbidimetry to calculate the PGI/PGII ratio （PGR）. Results In cirrhotic patients, the levels of serum PGI and PGR were lower than those in the healthy controls. The patients without PHG had a serum PGI level of 49.48＋23.86 ~g/L, significantly lower than that in PHG patients （74.85＋30.27 ~tg/L, P= 0,000）. The levels of serum PG II in patients with H.pylori infection was significantly higher that in patients free of H.pylori infection （P=0.003）. Conclusion The serum level of PGI decreases obviously in patients with hepatic cirrhosis and PHG, who can have damages of the gastric mucosa lamina propria and reduced secretory function of the gastric mucosa. H.pylori infection may affect the level of PGII. There is no significant correlation between serum PG level and liver function, but to a certain extent, serum PG level especially PGI can reflect the function of gastric mucosa in patients of liver cirrhosis.

关 键 词：肝硬化 胃粘膜病变 血清胃蛋白酶原 肝功能 

分 类 号：R575.2[医药卫生—消化系统]