血清胃蛋白酶原与胃泌素检测对消化性溃疡病的诊断价值

Diagnostic Value of Determination of Serum Pepsinogen and GastrinLevels in Patients with Peptic Ulcer

目的:探讨胃、十二指肠溃疡患者血清胃蛋白酶原(PG)、胃泌素(GS)水平变化规律及临床意义。 方法:采用免疫放射分析测定了100例正常人,61例十二指肠球部溃疡,46例胃溃疡患者,66例胃癌和101例 慢性胃炎患者血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、GS含量及PGⅠ/PGⅡ比值变化。结果:十二 指肠溃疡组和胃溃疡组PGⅠ、PGⅡ、PGⅠ/PGⅡ较对照组显著增高(P<0.001),GS水平较对照组、慢性胃炎 组明显增高(P<0.001),但明显低于胃癌组(P<0.001),十二指肠球部溃疡组PGⅠ、PGⅠ/PGⅡ水平较胃溃 疡组明显增高(P<0.001)。结论:过高的PGⅠ、PGⅡ、PGⅠ/PGⅡ、GS水平增高是溃疡病的高危因素之一,作 为一项血清学指标,对溃疡病的诊断及疗效观察有重要的临床意义。

Objective To investigate the clinical significance of changes of serum pepsinogen and gastrin levels in patients with gastric/duodenal ulcer. Methods Serum pepsinogen Ⅰ(PGⅠ), pepsinogenⅡ (PGⅡ), gastrin levels and PGⅠ/PGⅡ ratio were determined with RIA in 100 controls, 61 patients with duodenal ulcer, 46 patients with gastric ulcer, 66 patients with gastric cancer and 101 patients with chronic gastritis. Results In patients with peptic ulcer (gastric/duodenal), the serum levels of PGⅠ, PGⅡ and PGⅠ/PGⅡ ratio were significantly higher than those in controls (P<0.001); the serum gastrin levels were also significantly higher than those in controls and patients with chronic gastritis (P<0.001), but lower than those in patients with gastric cancer (P<0.001). Among patients with peptic ulcer, the serum PGⅠ level and PGⅠ/PGⅡ ratio were significantly higher in patients with duodenal ulcer than those in patients with gastric ulcer (P<0.001). Conclusion Excessive high serum levels of PGⅠ, PGⅡ, gastrin and PGⅠ/PGⅡ ratio were some of the high risk factors for peptic ulcer. Those were useful serum markers for diagnosis and follow-up of the disease.