血清胃蛋白酶原检测在慢性胃炎患者的诊断和随访中的临床意义

Clinical significance of serum pepsinogen detection in the diagnosis and follow-up of patients with chronic gastritis

目的通过检测不同类型慢性胃炎患者血清胃蛋白酶原的水平,探讨其在慢性胃炎患者诊断和随访中的临床意义。方法入组患者于胃镜前采用酶联免疫法检测血清胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ的水平并计算胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ比值。然后接受胃镜检查,并通过黏膜活检组织的病理组织学检查明确慢性胃炎的类型。根据胃镜及胃镜病理的结果分三组:A组(浅表性胃炎组)、B组(单纯萎缩性胃炎组)、C组(萎缩性胃炎合并低级别上皮内瘤变组)。结果共160例患者纳入本研究;血清胃蛋白酶原Ⅰ、血清胃蛋白酶原比值在A组(72.8±5.7ng/ml)、B组(68.9±6.4ng/ml)、C组(62.7±7.8ng/ml)中呈逐渐下降的趋势,三组经方差分析有统计学差异(P<0.05),组间两两比较经SNK法分析,任意组间也均存在统计学差异(P<0.05);在A组、B组、C组三组中,幽门螺杆菌感染患者的血清胃蛋白酶原Ⅰ水平、血清胃蛋白酶原比值均低于幽门螺杆菌感染阴性患者的水平,而幽门螺杆菌感染患者的血清胃蛋白酶原Ⅱ水平高于幽门螺杆菌阴性患者水平,差异具有统计学意义(P<0.05)。结论在慢性胃炎向萎缩性胃炎进展的过程中,血清胃蛋白酶原Ⅰ、血清胃蛋白酶原比值呈逐渐下降的趋势,且该检查相对于胃镜检查简便、安全,对慢性胃炎的随访和监测有一定的临床应用价值。

Objective To evaluate the clinical value of serum pepsinogen（PG）for chronic gastritis.Methods Before gastroscopy,pepsinogen were detected by enzyme-linked immunosorbent assay（ELISA）.The types of chronic gastric were diagnosed by endoscopic and pathological results.According to the types of chronic gastric,patients were divided into three groups.There were group A（chronic superficial gastritis）,group B（chronic atrophic gastritis）,group C（chronic atrophic gastritis with low grade intraepithelial neoplasia）.Results 160 patients were included.The level of PGI and PGR（PGI/PGII）in group B（68.9±6.4 ng/ml）and group C（62.7±7.8 ng/ml）were decreased compared to group A（72.8±5.7 ng/ml）（P〈0.05）;In each group,the level of PGI and PGR in Helicobacter pylori（HP）infection patients were decreased compared to no-HP infection patients,the difference has statistical significance Meaning（P〈0.05）.Conclusion The level of PGI and PGR were decreased according to the progressing and the severe of chronic gastritis,which suggesting that it maybe a good clinic test for monitoring the progress of chronic gastritis.