慢性乙肝、丙肝患者胃蛋白酶原水平的变化及其与肝功能异常的关系

Changes of pepsinogen levels in chronic HBV/HCV infected patients and their relationship with abnormal liver function

目的:探讨慢性乙肝、丙肝患者血清胃蛋白酶原(PG)水平是否受肝功能异常的影响。方法:选择130例肝功能异常的慢性乙肝、丙肝患者(肝病组)和200例健康体检者(正常对照组),采用ELISA法检测血清PGⅠ、PGⅡ浓度,计算PGⅠ/PGⅡ比值,比较两组血清PGⅠ、PGⅡ浓度及其比值。将肝病患者按照谷丙转氨酶、谷草转氨酶、白蛋白、总胆红素单项指标是否正常分组,比较PGⅠ、PGⅡ以及其比值的差异。结果:肝病组PGⅠ(155.21±93.55 ng/mL)、PGⅡ(16.27±11.95 ng/mL)水平明显高于正常对照组(P<0.001),PGⅠ/PGⅡ比值(12.82±8.1)低于正常人群(P<0.05)。谷丙转氨酶、谷草转氨酶、白蛋白、总胆红素水平与PGⅠ、PGⅡ及其比值无关(P>0.05)。结论:病毒感染导致的慢性肝病可影响血清PGⅠ、PGⅡ水平,而这种影响作用并不依赖肝细胞损伤或肝脏合成功能损伤,可能与病毒导致的胃粘膜损伤有关。

Objective:To investigate if abnormal liver function has an effect on serum pepsinogen(PG) level. Methods:130 cases of HBV/HCV infected patients prior treatment were selected as the liver disease group and 200 cases of physical examination were randomly chosen as the control group. Serum PG levels were measured by enzyme?linked immune-sorbent assay (ELISA). The PGⅠ/PGⅡ ratio was calculated. The four liver functions of glutamic pyruvic transaminase, glutamic oxalacetic transaminase, total albumin and total bilirubin were selected for analyses. According to the clinical standard of each function, these HBV/HCV infected patients were divided into abnormal group and the normal group.PGⅠ, PGⅡand PGⅠ/PGⅡ level were evaluated to see if there's any difference between the abnormal group and the normal group. Results: The levels of PGⅠ(155.21±93.55 ng/mL) and PGⅡ(16.27±11.95 ng/mL) were significantly higher in patients infected by HBV/HCV than in the controls(P<0.001). However,the PGⅠ/ PGⅡ level(12.82±8.1)was significantly lower than in the control group(P<0.05). Glutamic pyruvic transaminase, glutamic oxalacetic transaminase, total albumin and total bilirubin didn't affect PGⅠ, PGⅡand PGⅠ/PGⅡlevels in patients infected by HBV/HCV(P>0.05). Conclusion:PGⅠ, PGⅡand PGⅠ/PGⅡlevels changed in patients whose liver functions were abnormal. However,these changes were not related with Glutamic pyruvic transaminase, glutamic oxalacetic transaminase, the total albumin and the total bilirubin levels. The potential mechanism needs to be further investigated.