高血压患者中幽门螺杆菌感染引起胃蛋白酶原改变

Changes of serum pepsinogen Ⅰ/Ⅱ ratio induced by Helicobacter pylori infection in hypertensive patients

目的检测并分析幽门螺杆菌(HP)的感染所致胃蛋白酶原(PG)Ⅰ/Ⅱ比值在高血压患者中的变化,为PG检测在高血压患者中的临床应用提供指导依据。方法选择我院288名高血压患者,分析幽门螺杆菌(Hp)感染对高血压患者PGⅠ/Ⅱ比值、收缩压、舒张压、总胆固醇、甘油三酯及HDL的影响;观察不同高血压分级、肾损害及眼底损害患者PGⅠ/Ⅱ比值的变化;对PGⅠ/Ⅱ比值与高血压患者总胆固醇、甘油三酯及HDL进行相关分析;受试者工作曲线(ROC)测试PGⅠ/Ⅱ比值对高血压患者肾损害及眼底病变检测效能。结果较之非Hp感染患者,Hp感染患者中PGⅠ/Ⅱ比值明显降低,总胆固醇、甘油三酯明显增高(P<0.05),而收缩压、舒张压及HDL无明显差异(P>0.05);PGⅠ/Ⅱ比值在不同高血压分级的患者无明显差异,在肾损害及眼底损害患者中明显降低(P<0.05);PGⅠ/Ⅱ比值与高血压患者总胆固醇及甘油三酯呈显著负相关;PGⅠ/Ⅱ比值对高血压患者肾损害及眼底病变诊断效能ROC曲线下面积分别为0.79和0.82。结论高血压肾损害及眼底病变患者PGⅠ/Ⅱ比值明显降低,PGⅠ/Ⅱ比值可能作为高血压患者器官损害的筛查或者辅助检查指标。

Objective To investigate the changes in serum pepsinogen （PG） Ⅰ/Ⅱ ratio induced by Helicobacter pylori （Hp） infection and assess the value of PG Ⅰ/Ⅱ test in evaluating organ damages in hypertensive patients. Methods The serum total cholesterol, triglycerides, high density lipoprotein （HDL） and PGⅠ/Ⅱ ratio were tested in 288 hypertensive patients with or without Hp infection. The PG Ⅰ/Ⅱ ratio between the patients with different grade of hypertension, patients with and without hypertensive nephropathy, patients with and without hypertensive retinopathy. The relationship of PG Ⅰ/Ⅱ ratio with serum total cholesterol, triglycerides and HDL was analyzed with Pearson＇s correlation analysis and the effectiveness of PG Ⅰ/Ⅱ ratio in the the diagnosis of nephropathy and retinopathy was evaluated by receiver-operating characteristic curve （ROC） analysis. Results Compared with patients without Hp infection, the Hp-infected patients showed significantly decreased PG Ⅰ/Ⅱ ratio and increased total cholesterol and triglycerides （P〈0.05）, but their HDL levels, systolic pressure and diastolic pressure were comparable （P〉0.05）. PG Ⅰ/Ⅱ ratio was significantly decreased in patients with nephropathy and retinopathy compared with the patients without nephropathy and retinopathy （P〈0.05）, and was similar between patients with different grades of hypertension （P〉0.05）. PG Ⅰ/Ⅱ ratio was negatively correlated with serum total cholesterol and triglycerides in the hypertensive patients （P〈0.05）, and its area under curve （AUC） of ROC was 0.79 and 0.82 in the diagnosis of nephropathy and retinopathy, respectively. Conclusions Hypertensive patients with nephropathy and retinopathy have obviously decreased PG Ⅰ/Ⅱ ratio, which can be used for screening organ damages in hypertensive patients.