检测反流性食管炎患者血清胃蛋白酶原和幽门螺杆菌抗体的临床意义

Clinical Significance of Detecting Serum Pepsinogen and Anti-Helicobacter Pybri Levels in Patients with Reflux Esophagitis

目的 探讨血清胃蛋白酶原（PG）含量和幽门螺杆菌（Hp）感染与反流性食管炎（RE）的关系.方法 经胃镜检查诊断RE患者31例,其中0级10例,Ⅰ级8例,Ⅱ级7例,Ⅲ级6例,正常对照组20例.用乳胶增强免疫比浊法测定血清中的PGⅠ和PGⅡ含量,同时计算出PGⅠ/PGⅡ比值（PGR）.另外采用酶联免疫法分析血清抗幽门螺杆菌IgG抗体.结果 RE分级越高组的患者PGⅠ的含量越低（依次为112.2±14.4 ng/ml;88.2±9.8 ng/ml;76.1±10.2 ng/ml;62.4±13.5 ng/ml）;RE各分级组间PGⅠ含量和PGR值差异均有统计学显著性意义（F=128.71,P〈0.01;F=88.45,P〈0.01）,PGⅡ含量（依次为45.1±5.1 ng/ml;46.3±4.2 ng/ml;47.5±4.4 ng/ml;49.7±5.7 ng/ml）相比差异无统计学显著性意义（F=1.72,P〉0.05）;血清抗Hp抗体阳性的RE患者血清PGⅠ含量（78.2±10.4 ng/ml）及PGR（55.2±11.6 ng/ml）比血清抗Hp抗体阴性的RE患者低,两组相比均差异有统计学显著性意义（t=23.14,P〈0.01;t=48.26,P〈0.01）.结论 PG含量变化和Hp感染与RE病变程度有关,联合检测PG和Hp对诊疗RE具有积极的意义.

Objective To investigate the relationship between serum pepsinogenlevels as well as anti-Hp IgG with reflux esophagitis. Methods 31 cases were selected in the study,Reflux Esophagitis were diagnosed by endoscopy including 10 cases of 0 grade,8 cases of Ⅰ grade,7 cases of Ⅱ grade,6 cases of Ⅲ grade,and 20 normal subjects were measured serum pepsingen Ⅰ ,pepsinogen Ⅱ levels by lactoprene immunoturbidimetrie assay and calculate PG Ⅰ /PG Ⅱ ratio（PGR）. Anti-Hp IgG were detected by ELISA assay. Results PG Ⅰ level （112.2±14.4 ng/ml;88.2±9.8 ng/ml;76.1 ± 10. 2 ng/ml; 62.4±13.5 ng/ml） were gradually deereasd from 0 grade to ｜ grade. There were obvious differences of PG I lesel and PGR among different grade of reflux esophagitis （F=128.71,P〈0. 01;F=88.45,P〈0. 01）,however on differences of PG level （45.1±5.1 ng/ml ; 46.3±4.2 ng/ml; 47.5 ± 4.4 ng/ml ; 49.7 ± 5.7 ng/ml） （F = 1.72, P〉 0. 05）. Serum PG I level （78.2±10. 4 ng/ml） and PGR （55.2±11.6 ng/ml） in positive anti-Hp IgG groups were significantly lower than that in negative anti-Hp IgG groups. There was obvious differences between two group （t=23.14,P〈0. 01 and t=48.26,P〈 0. 01）. Conclusion The combined detection of PG level and anti-ttp IgG were valuable for diagnosis of reflux esophagitis and its pathological changes.