血清胃蛋白酶原在慢性胃部病变中变化的临床研究  

Clinical study on the changes of serum pepsinogen in chronic gastric lesions

作　　者：陈春春 罗和生[1] 成镀[1] 张维兰 田景媛 CHEN Chunchun;LUO Hesheng;CHENG Du;ZHANG Weilan;TIAN Jingyuan(Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《胃肠病学和肝病学杂志》2018年第11期1265-1269,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析不同胃部病变发生情况下血清胃蛋白酶原(pepsinogen,PG)表达水平,为消化系统疾病的临床诊断提供一定帮助。方法收集2015年7月至2017年4月武汉大学人民医院住院患者372例,包括312例胃部病变患者和60例无胃部病变者(对照组)。根据胃部病变不同可分为幽门螺旋杆菌(Helicobacter pylori,H. pylori)感染、胃炎、消化性溃疡、胃癌前病变、胃癌,其中胃炎包括浅表性胃炎组、糜烂性胃炎组、萎缩性胃炎组;消化性溃疡包括胃溃疡组、十二指肠球部溃疡组、复合溃疡组;胃癌前病变包括胃息肉组及残胃吻合口炎组。采用全自动生化分析仪检验血清PG(PGⅠ和PGⅡ)表达情况,并求PGⅠ与PGⅡ的比值(PGR),采用t检验及方差分析对各组的PG水平差异进行分析比较。结果 H. pylori感染组与对照组比较,PGⅠ、PGⅡ水平及PGR值明显升高,差异有统计学意义(P <0. 05)。在胃炎各组中,浅表性胃炎组PGⅠ、PGⅡ水平及PGR值与对照组相比,差异无统计学意义(P> 0. 05);糜烂性胃炎组与对照组比较,PGⅠ水平、PGR值明显升高,差异有统计学意义(P <0. 05),PGⅡ水平升高,但差异无统计学意义(P> 0. 05);萎缩性胃炎组PGⅠ、PGⅡ水平及PGR值与对照组相比均明显下降(P <0. 05)。在消化性溃疡各组中,胃溃疡组患者与对照组进行比较,PGⅠ、PGⅡ水平均明显升高(P <0. 05),PGR值变化不大差异无统计学意义(P> 0. 05);与对照组比较,十二指肠球部溃疡组及复合溃疡组PGⅠ、PGⅡ水平及PGR值明显升高(P <0. 05)。在癌前病变中,胃息肉组与对照组相比,PGⅠ水平及PGR值均显著升高(P <0. 05),PGⅡ水平也升高,但差异无统计学意义(P> 0. 05);残胃吻合口炎组PGⅠ、PGⅡ水平和PGR值与对照组相比均明显下降(P <0. 05)。胃癌组与对照组比较,PGⅠ水平、PGR值均明显下降(P <0. 05),PGⅡ水平升高,但差异无统计学意义(P> 0. 05)。结论血清PGⅠ、PGⅡ水平和PGR值Objective To investigate the expression of serum pepsinogen（ PG） in patients with different chronic gastric diseases,and proved helps in the clinical diagnosis of digestive disease. Methods Three hundred and seventytwo hospitalized patients were included in the Renmin Hospital of Wuhan University from Jul. 2015 to Apr. 2017,including 312 patients with stomach diseases and 60 patients without stomach diseases（ normal controls）. These major diseases were divided into 5 categories according to the different gastric lesions,which included H. pylori infection,gastritis,peptic ulcer,gastric cancer and gastric precancerous lesions; and gastritis included superficial gastritis,erosive gastritis and atrophic gastritis. Peptic ulcer included gastric ulcer,duodenal ulcer and compound ulcer. Precancerous lesions included polyps and stomatitis. The expression of PG（ PGⅠand PGⅡ） in serum was tested by automatic biochemical analyzer,and the ratio of PGⅠto PGⅡ（ PGR） was calculated. The difference PG level in each group was analyzed by t test and ANOVA. Results Compared with control group,the expressions of PGⅠ,PGⅡ and PGR in H. pylori infection patient was significantly higher（ P〈0. 05）. In gastritis groups,the expressions of PGⅠ,PGⅡ and PGR in superficial gastritis,the change was not obvious compared with control group（ P〉0. 05）; compared with control group,the expressions of PGⅠand PGR in erosive gastritis group were increased significantly（ P〈0. 05）,the expression of PGⅡwas increased,but there was no statistically significant（ P〉0. 05）; the expressions of PGⅠ,PGⅡand PGR in atrophic gastritis were significantly decreased significantly compared with control group（ P〈0. 05）. In peptic ulcer groups,the expressions of PGⅠ,PGⅡ in gastric ulcer group were significantly higher than those in normal control group（ P〈0. 05）,and there was no significant difference in PGR value between gastric ulcer group and normal control group（ P〈0. 05）. The expressio

关 键 词：慢性胃部病变 胃蛋白酶原 变化 

分 类 号：R573[医药卫生—消化系统]