空腹血清胃蛋白酶原和胃泌素-17对萎缩性胃炎的诊断价值  

Diagnostic value of serum pepsinogen and gastrin-17 in patients with atrophic gastritis

作　　者：马曼茹 李修岭[2] 丁松泽[2] 李晓芳[2] 房新辉[2] 丁辉[2] 黄宇博 蒋振华 李毅 晁帅恒 MA Man-ru;LI Xiu-ling;DING Song-ze;LI Xiao- fang;FANG Xin-hui;DING Hui;HUANG Yu -bo;JIANG Zhen -hua;LI Yi;CHAO Shuai -heng(Graduate Department of Xinxiang Medical University, Xinxiang, Henan 453003, Chin)

机构地区：[1]新乡医学院研究生处,河南新乡453003 [2]河南省人民医院消化内科,郑州450003

出　　处：《医药论坛杂志》2018年第2期17-20,共4页Journal of Medical Forum

基　　金：河南省卫生和计划生育委员会省部共建项目(201701023)

摘　　要：目的研究空腹血清胃蛋白酶原(PG)和胃泌素-17(G-17)对萎缩性胃炎的诊断价值。方法选取2016年10月至2017年5月因胃部不适在河南省人民医院行胃镜检查且H.pylori抗体阳性患者共213例,根据组织病理学诊断结果进行分组,萎缩性胃炎95例,非萎缩性胃炎118例;胃窦萎缩性胃炎组45例,胃体萎缩性胃炎组28例,全胃萎缩性胃炎组22例;轻度萎缩性胃炎组54例,中度萎缩性胃炎组31例,重度萎缩性胃炎组10例。入选患者在行胃镜检查前用酶联免疫吸附测定(ELISA)方法检测其空腹血清PG、G-17水平,H.pylori抗体阳性为定性分析,根据内镜和病理结果,评估G-17联合PGⅠ、PGR对慢性萎缩性胃炎的诊断价值。结果按照标准共纳入213例,其中萎缩性胃炎95例,非萎缩性胃炎118例。萎缩性胃炎组血清PGⅠ、PGR水平低于非萎缩性胃炎组(P<0.05);萎缩性胃炎组与非萎缩性胃炎组之间血清G-17水平差异无统计学意义(P>0.05)。重度萎缩性胃炎组PGⅠ、PGR水平分别低于中度萎缩性胃炎组、轻度萎缩性胃炎组(P>0.05)。萎缩性胃体胃炎组的PGⅠ、PGR水平低于萎缩性胃窦胃炎组(P<0.05)。萎缩性胃窦胃炎组G-17水平低于萎缩性胃体胃炎组(P<0.05)。根据ROC曲线,PGⅠ、PGR两者诊断萎缩性胃炎的最佳临界值分别为85.60μg/L、7.1。结论血清G-17、PG分别是胃窦萎缩和胃体萎缩的标志,PGⅠ<85.60μg/L,PGR<7.1,可作为具有萎缩性胃炎风险建议行胃镜及组织学检查的依据。Objective To improve the detection rate of atrophic gastritis,serum gastrin-17（G-17）,pepsinogen I and II（PGs） were evaluated for screening of chronic atrophic gastritis. Methods From October 2016 to March 2017,a total of 213 cases of patients were enrolled in our study,all patients have stomach discomfort or upper digestive disease symptoms. According to the results of histopathological diagnosis,the group was divided into a group of 95 cases of atrophic gastritis and a control group of 118 non-atrophic gastritis patients. The diagnosis was made by combining endoscopy and pathology results,G-17,PGs and PGR value were measured to evaluate their value in diagnosing chronic atrophic gastritis. Results Among 213 patients,the PGⅠ and PGR levels of 95 cases atrophic gastritis were lower than that in 118 cases of non-atrophic gastritis patients（P〈0. 05）; The PGⅠ and PGR levels of severe atrophic gastritis group were lower than that of moderate atrophic gastritis and mild atrophic gastritis groups,but the difference between them was not significant（P〉0. 05）. The G-17 level in of atrophic gastritis group were lower than that in gastric body atrophic groups,but the difference between them was not significant（P〉0. 05）. According to ROC curve analysis,we noted that the optimal threshold of serum PGⅠ and PGR in diagnosis of atrophic gastritis is 85. 6 μg/L,7. 1 respectively. Conclusion For patients with gastrointestinal symptoms,PGⅠ≤85. 6μg/L、PGR≤7. 1 can be considered as a high risk factor for atrophic gastritis,and the patients is suggested to receive gastric endoscopy examination for further evaluation.

关 键 词：胃蛋白酶原类 胃泌素 萎缩性胃炎 幽门螺杆菌抗体 

分 类 号：R573.3[医药卫生—消化系统]