慢性胃病患者胃蛋白酶原Ⅰ、Ⅱ水平与幽门螺旋杆菌感染的关系研究

The Relationship Between the Levels of Pepsinogen Ⅰ, Ⅱ and Helicobacter Pylori Infection in Patients with Chronic Gastric Disease

目的:探讨慢性胃病患者胃蛋白酶原(PG)Ⅰ、PG Ⅱ水平与幽门螺旋杆菌(HP)感染的关系。方法:选取2012年12月-2016年12月期间我院收治的慢性胃病患者64例作为研究对象,根据疾病类型分为慢性胃炎组23例、胃溃疡组22例以及胃癌组19例。另取同期于我院接受体检的健康志愿者30例作为对照组,应用免疫比浊法测定各组血清PG Ⅰ与PG Ⅱ水平,采用快速尿激酶法测定各组HP感染情况,分别对比各组研究对象HP感染发生情况,血清PG Ⅰ、PG Ⅱ、PG Ⅰ/PG Ⅱ水平,HP感染情况与血清PG Ⅰ、PG Ⅱ、PG Ⅰ/PG Ⅱ水平关系。结果:慢性胃炎组、胃溃疡组以及胃癌组患者HP阳性率分别为60.87%、63.64%、78.95%,均明显高于对照组的13.33%(P<0.05)。慢性胃炎组、胃溃疡组以及胃癌组患者血清PG Ⅰ、PG Ⅰ/PG Ⅱ水平均低于对照组,且胃癌组低于慢性胃炎组与胃溃疡组(P<0.05),慢性胃炎组和胃溃疡组血清PG Ⅰ、PG Ⅰ/PG Ⅱ水平比较差异无统计学意义(P>0.05),各组血清PG Ⅱ比较无统计学差异(P>0.05)。各组研究对象HP阳性血清PG Ⅰ、PG Ⅰ/PG Ⅱ水平均低于HP阴性(P<0.05),而PG Ⅱ水平比较无统计学差异(P>0.05),慢性胃炎组、胃溃疡组、胃癌组HP阳性血清PG Ⅰ水平低于对照组,且胃癌组低于慢性胃炎组、胃溃疡组(P<0.05),胃溃疡组、胃癌组HP阳性血清PG Ⅰ/PG Ⅱ水平低于对照组,且胃癌组低于慢性胃炎组(P<0.05)。结论:慢性胃病患者PG Ⅰ、PG Ⅱ水平异常降低,HP阳性患者PG Ⅰ、PG Ⅱ水平降低更为明显,随病变的程度增加,血清PG Ⅰ、PG Ⅰ/PG Ⅱ水平也呈现出下降的趋势。

Objective： To study the relationship between pepsinogen（PG） Ⅰ, Ⅱ level and Helicobacter pylori（HP） infection in patients with chronic gastric disease. Methods： 64 cases with chronic gastric disease who were treated in our hospital from December 2012 to December 2016 were selected as the subjects, which were divided into chronic gastritis group（23 cases）, gastric ulcer group（22 cases）and gastric cancer group（19 cases） according to the type of disease. Another 30 healthy persons in our hospital during the same period were selected as the control group. The serum levels of PG Ⅰ and PG Ⅱ in each group were measured by immunoturbidimetry, the HP infection rate in each group was determined by rapid urokinase method, the incidence of HP infection, the serum levels of PG Ⅰ, PG Ⅱ, PG Ⅰ/PG Ⅱ in each group were compared, the relationship between HP infection and serum level of PG Ⅰ, PG Ⅱ and PG Ⅰ/PG Ⅱ were compared. Results： The positive rates of HP in chronic gastritis group, gastric ulcer group and gastric cancer group were 60.87%, 63.64% and 78.95%, respectively, which were significantly higher than 13.33% of the control group（P〈0.05）. The serum levels of PG Ⅰ, PG Ⅰ/PG Ⅱ in chronic gastritis group, gastric ulcer group and gastric cancer group were lower than those in the control group, and the gastric cancer group were lower than that in chronic gastritis group and gastric ulcer group（P〈0.05）, there was no significant difference in serum PG Ⅱ in each group（P〉0.05）. The levels of PG Ⅰ and PG Ⅰ/PG Ⅱ in the HP positive of all the subjects were lower than that of HP negative（P〈0.05）,there was no significant difference in serum PG Ⅱ in each group（P〉0.05）, serum PG Ⅰ levels of HP positive in chronic gastritis, gastric ulcer group and gastric cancer group were lower than those in the control group, and the gastric cancer group were lower than those of chronic gastritis, gastric ulcer group（P〈0.05）, the level of PG Ⅰ/PG Ⅱ of HP positive serum in gastric ulcer group and gastric cancer group was lower than that of the control group, and the gastric cancer group was lower than that of the chronic gastritis group（P〈0.05）. Conclusion： The levels of PG Ⅰ and PG Ⅱ in patients with chronic gastric disease are decrease, the levels of PG Ⅰ and PG Ⅱ in HP positive patients decreased more significantly, the level of serum PG Ⅰ and PG Ⅰ/PG Ⅱ also show a declining trend with the increase of the degree of disease.