慢性胃疾病患者血清胃蛋白酶原水平变化观察及临床意义

目的探讨慢性胃疾病中血清胃蛋白酶原（PG）水平变化对疾病诊断的意义。方法使用酶联免疫吸附实验（ELISA）检测由胃镜及病理诊断为慢性萎缩性胃炎（CAG）患者55例，十二指肠球部溃疡（DU）35例，浅表性胃炎（CSG）115例，胃癌（GC）患者8例的血清PG-Ⅰ和PG-Ⅱ水平及PGR比值，以及幽门螺杆菌（Hp）感染情况，进行统计学分析。结果胃癌、萎缩性胃炎与浅表性胃炎、十二指肠球部溃疡组比较。血清PG-I、PGR水平明显低于其他组，差异有统计学意义（P〈0．05）。PG—I为90．3μg／t．N诊断CAG的感性为87．3％，特异性56．5％。PG-I为88．5μg／L时诊断胃癌的敏感性为72．9％，特异性42．2％。Hp感染与血清PQ水平变化在疾病组内差异无统计学意义（P〉0．05）。结论血清PG水平的变化，尤其是PG—I的降低对诊断慢性萎缩性胃炎以及胃癌中有一定的临床价值，可作为临床胃镜检查前的一项筛查指标。

Objective To investigate the disease diagnosis value of serum pepsinogen （ PG ） level changes in chronic stomach diseases. Methods Using enzyme-linked immunosorbent assay （ ELISA ） tested serum PG-Ⅰ, PG- Ⅱ levels, PGR ratio and Helicobacter pylori （ Hp ） infection situation from 55 patients of CAG, 35 cases of duodenal bulb ulcer, 115 cases of superficial gastritis and 8 cases of gastric cancer diagnosed by gastroscope and pathological, then carried on the statistical analysis. Results The serum PG-Ⅰ, PGR levels of atrophic gastritis and gastric cancer groups were significantly lower than the superficial gastritis and duodenal bulb ulcers groups with significant statistical difference （ P〈0.05 ） .When the PG-Ⅰ level at 90.3 μg/L, the sensitivity was 87.3% and the specificity was 56.5% in diagnosis of the CAG, but PG-Ⅰ was 88.5 μg/L, the sensitivity diagnosis of GC was 72.9%, and the specificity was 42.2%.It is no significant statistical difference between Hp infection and serum PG level changes in these disease groups （ P〉0.05 ） . Conclusion The changes of serum PG level, especially the lower PG-Ⅰ have certain clinical value in the diagnosis of chronic atrophic gastritis and gastric cancer, it can be used as screening indexes before gastroscopy.