胃蛋白酶原在消化性溃疡中的表达及意义

目的探讨幽门螺旋杆菌（Hp）感染对血清胃蛋白酶原（sPG）水平的影响，评估sPG水平在Hp相关性消化性溃疡黏膜修复前后的变化。方法分别收集经胃镜和病理证实的正常胃黏膜（即轻型慢性浅表性胃炎）患者（正常组，其中分为Hp阳性组和Hp阴性组）和Hp感染的良性消化性溃疡患者（溃疡组，分为治疗前及治疗后组）。测定各组患者sPG水平，进行对比分析。结果（1）各组年龄、性别差异无统计学意义。（2）Hp＋组与Hp一组比较，sPGI和sPGII水平均差异有统计学意义，sPGR（sPGI／sPGII）差异无统计学意义。（3）仅sPGI水平在正常Hp＋组分别与DU治疗前组、Gu治疗前组比较时差异有统计学意义。（4）GU患者治疗前后比较，仅sPGI水平差异有统计学意义。DU患者治疗前后比较，sPGI和sPGII水平差异均有统计学意义。结论Hp感染可使sPG水平升高，sPG在H．pylori相关性溃疡黏膜修复前后有改变．且sPGI水平可考虑作为判断溃疡黏膜愈合情况的良好指标之一。

Objective To investigate whether Hp can influence the serum PG level, and to assess the sPG level in people with peptic ulcer before and after treatment. Methods People with normal gastric mucosa （ normal group： normal Hp＋ group, normal Hp- group ） and patients with benign peptic ulcer （ PU group ） who confirmed by endoscopy and pathology were collected. All patients were given serum PG examination （ fasting ） at the same day of endoscopy before treatment. After treatment, patients in PU group accepted the same examination as that before treatment. The serum PG level were determined and the results were statistically analyzed. Results There was no difference between each group in age or gender. The sPGI and sPGII levels were higher in Hp＋ group than in Hp-group. Comparing with Hp＋ group, the sPGI level was significant higher in PU group. But there was no difference between GU group and DU group. Atier the treatment, the sPGI and sPGII levels obviously decreased in DU group, only sPGI decreased patently in GU group. Conclusion The sPG level in Hp＋ patients is higher than that in normal person, and the sPG level in Hp＋ patients with peptic ulcer is higher than the former. After the mucosa have healed, the sPG level decreased significantly, especially sPGI. Thus, the sPGI level can be considered as a good indicator for evaluating mucosal healing of peptic ulcer.