血浆Ghrelin浓度在胃良恶性疾病中的临床意义

Clinical significance of plasm Ghrelin levels in gastric benign and malignant diseases

目的探讨各种胃病血浆Ghrelin浓度的变化及其与幽门螺杆菌感染（H.pylor,HP）的关系。方法收集临床经内镜确诊的急性胃炎、慢性胃炎、胃溃疡、良性胃息肉与胃癌患者血浆标本,采用ELISA法检测Ghrelin浓度,采用尿素14C呼气试验检测患者HP感染状态。结果急性胃炎、胃良性息肉、胃癌组血浆Ghrelin浓度与正常胃黏膜组比较均显著升高（P〈0.05~0.01）,而慢性胃炎组则显著下降（P〈0.01）,胃溃疡组无显著性变化（P〉0.05）。HP阳性组的血浆Ghrelin浓度较阴性组显著下降（P〈0.01）。其中胃良性息肉、胃癌组中,HP阳性患者的血浆Ghrelin水平较HP阴性患者显著降低（P〈0.01）,而急性胃炎、慢性胃炎、胃溃疡患者的血浆Ghrelin水平与HP感染无显著变化（P〉0.05）。结论血浆Ghrelin浓度水平在各种胃病中变化较大,可能反映了胃黏膜的炎症及萎缩病变情况,具体的病理生理学机制尚有待进一步研究。

[Objective] To explore the variation of plasma Ghrelin levels in various gastric benign and malignant diseases and the relationship with H.pylor （HP） infection. [Methods ] Plasma samples of acute gas- tritis, chronic gastritis, gastric ulcer, benign gastric polyp and gastric cancer determined by upper gastrointesti- nal endoscopy were collected. The plasma Ghrelin levels were detected by ELISA. The HP infection status was determined by Urea C14 breath test. [Results] Plasma Ghrelin levels in acute gastritis, gastric benign polyp and gastric cancer increased comparing with normal gastric mucosa （P 〈0.05-0.01）, while decreased in chronic gastritis （P〈0.01）, and had no change in gastric ulcer （P〉0.05）. Plasma Ghrelin levels in HP positive group decreased comparing with HP negative group （P〈0.01）. For the gastric benign polyp and gastric cancer groups, plasma Ghrelin levels of HP positive group decreased comparing with HP negative group, while for a- cute gastritis, chronic gastritis and gastric ulcer, there was no eorelationship （P〉0.05）. [Conclusion] Plasma Ghrelin levels vary widely in various gastric benign and malignant diseases, reflecting the inflammatory and a- trophic lesions of the gastric mueosa. The detailed pathophysiologieal mechanisms remains to be further inves- tigated.