胃蛋白酶原、胃泌素-17和幽门螺杆菌对萎缩性胃炎的诊断价值  

Diagnostic value of pepsinogen,gastrin-17 and Helicobacter pylori for atrophic gastritis

作　　者：阳仕雄 沈婷 刘语新 付汉东[1] YANG Shixiong;SHEN Ting;LIU Yuxin;FU Handong(Central Laboratory,Xiaogan Hospital Affiliated to Wuhan University of Science and Technology/Xiaogan Central Hospital,Xiaogan,Hubei 432000,China)

机构地区：[1]武汉科技大学附属孝感医院/孝感市中心医院中心实验室

出　　处：《检验医学与临床》2019年第14期1957-1960,共4页Laboratory Medicine and Clinic

基　　金：湖北省自然科学基金项目(2018CFB786);湖北省卫生健康委员会科研项目(WJ2019F121)

摘　　要：目的探讨血清胃蛋白酶原(PG)Ⅰ、PGⅡ、PGⅠ/PGⅡ比值(PGR)、胃泌素-17(G-17)和幽门螺杆菌(Hp)对萎缩性胃炎的早期诊断价值。方法选取2016年12月至2018年6月来武汉科技大学附属孝感医院消化内科和胃肠外科就诊的660例萎缩性胃炎患者纳入研究组,根据胃镜结果和病理诊断结果分为轻度组(236例)、中度组(323例)和重度组(101例),选择同期50例怀疑胃炎到该院进行进一步检测,最终排除胃部疾病者纳入对照组。收集所有研究对象空腹血清标本,采用ELISA检测血清中PGⅠ、PGⅡ、G-17水平,并计算PGR,采用胶体金法检测Hp。结果随着胃黏膜萎缩程度加重,PGⅠ和PGR水平逐渐降低,PGⅡ和G-17水平逐渐升高。轻度组、中度组、重度组与对照组比较,PGⅠ、PGR和G-17水平均明显降低,PGⅡ水平及Hp阳性率均明显升高,差异均有统计学意义(P<0.05)。根据受试者工作特征曲线,PGⅠ、PGⅡ、PGR、G-17诊断萎缩性胃炎的最佳临界值分别为82.365 μg/L、9.958 μg/L、10.395、9.624 pmol/L。结论检测血清PGⅠ、PGⅡ、G-17和Hp在萎缩性胃炎中有较高的诊断价值,对防止癌前病变具有重要临床意义。Objective To investigate the effects of serum pepsinogen (PG)Ⅰ,PGⅡ,PGⅠ/PGⅡ ratio (PGR),gastrin-17 (G-17) and Helicobacter pylori (Hp) on atrophic gastritis.Methods A total of 660 patients diagnosed as atrophic gastritis in department of gastroenterology and gastrointestinal surgery in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from December 2016 to June 2018 were selected into study group,and divided into mild atrophic gastritis group (236 cases),moderate atrophic gastritis group (323 cases) and severe atrophic gastritis group (101 cases) according to endoscopic findings and pathological diagnosis,and 50 persons without gastric diseases were recruited into control study.The fasting serum samples were collected,and the serum PGⅠ,PGⅡ,PGR,G-17 were simultaneously detected by ELISA,and Hp was detected by colloidal gold method.Results Compared with control group,PGⅠ,PGR and G-17 decreased,PGⅡ and Hp positive rate increased in other three groups,the differences were statistically significant (P<0.05).And with the severity of atrophy increased,PGⅠ,PGR gradually decreased,PGⅡ and G-17 gradually increased.According to the receiver operating characteristic curve,the optimal cut-off values for PGⅠ,PGⅡ,PGR,and G-17 in diagnosis of atrophic gastritis were 82.365 μg/L,9.958 μg/L,10.395,and 9.624 pmol/L.Conclusion Detection of serum PGⅠ,PGⅡ,G-17 and Hp has high diagnostic value in atrophic gastritis,and has important clinical significance in prevention of precancerous lesions.

关 键 词：胃蛋白酶原 胃泌素-17 幽门螺杆菌 萎缩性胃炎 

分 类 号：R446[医药卫生—诊断学]