不同证型慢性萎缩性胃炎血浆内皮素、降钙素基因相关肽相关性研究

Study on the Relationship Between Plasma Endothelin, Calcitonin Gene- related Peptide and Chronic Atrophic Gastritis of Different Syndromes

目的 :探讨血浆内皮素 (ET)、降钙素基因相关肽 (CGRP)含量与慢性萎缩性胃炎 (CAG)及其中医证型的关系。方法 :将 118例 CAG患者 (CAG组 )分为 5型 :肝胃不和型 2 6例 ,脾胃虚弱 (含虚寒 )型 38例 ,脾胃湿热型2 4例 ,胃阴不足型 18例 ,胃络瘀血型 12例。 30例慢性浅表性胃炎 (CSG)为 CSG组 ,30例健康体检者作为对照组。用放免法检测空腹静脉血 ET、CGRP含量。结果 :1CAG组血浆 ET水平明显高于、而 CGRP水平明显低于 CSG组和对照组 (均 P <0 .0 1) ;CSG组血浆 ET水平高于对照组 ,CGRP水平低于对照组 ,但两组比较差异无显著性意义 (P >0 .0 5 )。2轻、中、重度 CAG患者之间血浆 ET含量差异有显著性意义 (P <0 .0 5～ 0 .0 1) ;血浆 CGRP含量除中、重度 CAG间差异无显著性意义 (P >0 .0 5 )外 ,其余间的差异有显著性意义 (P <0 .0 5～ 0 .0 1)。 3CAG各中医证型血浆 ET、CGRP含量的差异有统计学意义 (P <0 .0 5～ 0 .0 1) ,ET含量由低向高及 CGRP含量由高向低的顺序是 :肝胃不和型→脾胃虚弱型→脾胃湿热型→胃阴不足型→胃络瘀血型。 4 CAG患者血浆 ET与 CGRP含量呈显著负相关 (r =- 0 .2 14 ,P <0 .0 5 )。结论 :血浆 ET、CGRP可能参与 CAG的病理生理过程 ,其含量的变化与萎缩程度有关。ET。

Objective: To investigate the relationship between the plasma endothelin (ET), calcitonin gene-related peptide (CGRP) and chronic atrophic gastritis (CAG) of different TCM syndromes.Methods: One hundred and eighteen cases of CAG were divided into five groups according to various clinical characters: 26 cases of incoordination between liver and stomach (group A); 38 cases of deficiency of spleen and stomach (group B);24 cases of damp-heat in spleen and stomach (group C);18 cases of deficiency of stomach-yin (group D); 12 cases of blood stasis of stomach (group E). 30 cases of chronic superficial gastritis (CSG) served as CSG group and 30 cases of healthy individuals served as control group. The levels of plasma ET and CGRP were measured by using radioimmunoassay.Results: (1) The levels of ET were significantly higher in the patients with CAG than those of CSG and controls (P< 0.01); The levels of CGRP were significantly lower in CAG patients than those of CSG and controls (P< 0.01); The levels of ET in CSG patients were higher than those of controls, while the levels of CGRP were lower than those of controls without statistical difference (P> 0.05). (2) The levels of ET had statistical difference among mild CAG, moderate CAG and severe CAG (P< 0.05～0.01); There was statistical difference in the levels of CGRP between mild CAG and moderate CAG or mild CAG and severe CAG (P< 0.05～0.01), while no statistical difference between moderate CAG and severe CAG was found (P> 0.05). (3) The levels of ET and CGRP showed a statistical difference among different TCM syndromes (P< 0.05～0.01). The levels of ET from the lowest to the highest and the levels of CGRP from the highest to the lowest were from group A to group E in turn. (4) The levels of ET were oppositely correlated with the levels of CGRP (r=-0.214, P< 0.05). Conclusion: (1) ET and CGRP were possibly involved in the pathophysiological process of CAG. (2) The levels of plasma ET and CGRP could be supporting objective indexes for dividing the TCM syndromes of CAG. (3) The imbalance of plasma ET/CGRP was possibly an objective index of blood stasis syndrome.