血清胃蛋白酶原检测对慢性胃炎筛查的作用研究

Study on the effect of serum pepsinogen detection in the screening of chronic gastritis

目的探讨胃蛋白酶原Ⅰ(PGⅠ)和胃蛋白酶原Ⅱ(PGⅡ)在慢性胃炎筛查中的作用。方法选择浅表性胃炎、萎缩性胃炎和体检人群,分别检测PGⅠ、PGⅡ和幽门螺旋杆菌(HP),并计算PGⅠ/PGⅡ比值(PGR);对浅表性胃炎患者根据HP感染分组,鉴别PGⅠ和PGⅡ与HP感染的关系;观察PGⅠ、PGⅡ和PGR对慢性胃炎的筛查作用。结果浅表性胃炎、萎缩性胃炎、残胃胃炎患者的血清PGⅠ和PGⅡ水平均高于对照组,而3组的PGⅠ/PGⅡ比值(PGR)均低于对照组,差异有统计学意义(P<0.05)。PGR在幽门螺旋杆菌阳性组低于阴性组,差异有统计学意义(P<0.05);PGR在活动性胃炎组显著低于非活动性胃炎组,差异有统计学意义(P<0.05);HP感染(阳性)与活动性胃炎呈显著正相关(r=0.719,P<0.01)。PGⅠ、PGⅡ和PGR联合检测萎缩性胃炎患者的阳性率为62.3%。结论慢性胃炎患者血清PGⅠ和PGⅡ显著高于正常人群,而PGR显著低于正常人群,将来可能用于慢性胃炎的筛查或辅助诊断。

Objective To evaluate the effect of serum pepsinogen Ⅰ and pepsinogen Ⅱ in the screening of chronic gastritis.Methods Serum samples were collected from superficial gastritis（ SG）,atrophic gastritis（ AG） and physical examinees for the detection of PG Ⅰ,PG Ⅱ and Helicobacter pylori（ HP）. And the ratio of pepsinogen Ⅰ/pepsinogen Ⅱ was calculated. SG patients were grouped according to HP infection,to verify the relationship of PG Ⅰ and PG Ⅱ; the screening effect of PGⅠ,PGⅡ and PGR to chronic gastritis was evaluated. Results PG Ⅰ and PG Ⅱ levels in SG,AG patients and gastritis patients with gastrectomy were higher than the control group. But PGR of the 3 groups was lower than the control group,with the differences statistically significant（ P〈 0. 05）. PGR in the HP positive group was significantly lower than that in the HP negative group,with the difference statistically significant（ P 〈0. 05）. PGR in the active gastritis group was significantly lower than that in the inactive gastritis group,with the difference statistically significant（ P〈 0. 05）. HP infection（ positive） was positively correlated with active gastritis（ r = 0. 719,P 〈0. 01）. The positive rate of the combined detection of the three indexes was 62. 3% in AG.Conclusion The serum PG I and PG II in patients with chronic gastritis were significantly higher than those in the physical examination group,but PGR was significantly lower. They may be used in the screening and diagnosis of chronic gastritis.