粪便Hp抗原检测对慢性萎缩性胃炎辅助诊断及病情评估的价值

Value of Fecal Hp Antigen Detection in Diagnosis and Assessment of Chronic Atrophic Gastritis

目的探讨粪便Hp抗原(HpSA)检测对慢性萎缩性胃炎(CAG)辅助诊断及病情评估的价值。方法选取2015年9月~2018年1月收治的CAG患者118例作为CAG组,同期进行常规胃镜体检并确诊健康的志愿者100例作为正常对照组,对两组研究对象粪便标本的HpSA阳性情况进行判定,并对比其胃肠激素[胃蛋白酶原Ⅰ(PGⅠ),胃蛋白酶原Ⅱ(PGⅡ)及胃泌素-17(G-17)],炎症因子[白介素-8(IL-8),白介素-11(IL-11),白介素-32(IL-32)及肿瘤坏死因子α(TNF-α)]含量的差异。结果CAG组患者粪便标本中HpSA阳性率显著高于正常对照组(82.20%vs8.0%),差异有统计学意义(χ^2=119.376,P=0.000),CAG组患者血清中PGⅠ的含量低于正常对照组(98.37±13.45vs55.19±7.43ng/ml),G-17水平高于正常对照组(163.05±22.74vs113.29±17.15ng/L),血清中炎症因子IL-8,IL-11,IL-32和TNF-α的含量高于正常对照组(12.01±1.85vs9.73±1.64pg/ml,16.19±1.84vs13.05±1.76pg/ml,24.11±3.76vs20.73±3.41pg/ml,7.61±0.89vs6.58±0.84pg/ml),差异均有统计学意义(t=6.902~29.915,均P=0.000),其中CAG组HpSA阳性患者上述指标含量变化程度大于HpSA阴性患者,差异有统计学意义(t=19.134,11.826,9.163,10.426,6.371,5.571,均P=0.000)。结论CAG患者的粪便HpSA阳性率显著高于胃黏膜正常者,而粪便HpSA阳性的CAG患者胃肠激素分泌紊乱与自身炎症反应均较为严重。

Objective To investigate the value of fecal Hp antigen(HpSA)detection in diagnosis and assessment of chronic atrophic gastritis(CAG).Methods 118 cases of CAG patients in Wuhan Third Hospital from September 2015 to January 2018 were treated as CAG group,100 cases of normal gastroscopy and healthy volunteers in the Third Hospital of Wuhan at the same time were chosen as normal control group.The HpSA positive conditions of two groups were determined,gastrointestinal hormones[pepsinogen I(PG I),pepsinogen II(PG II)and gastrin-17(G-17)],inflammatory factors[interleukins-8(IL-8),interleukin-11(IL-11),interleukin-32(IL-32),tumor necrosis factor alpha(TNF-alpha)]between two groups were compared.Results Positive rate of HpSA in stool specimens in CAG group was significantly higher than that in normal control group(82.20%vs 8.0%)the difference was statistically signficant(χ^2=119.376,P=0.000).Serum content of PG I in CAG group was lower than that in normal control group(98.37±13.45 vs 55.19±7.43 ng/ml),G-17 was higher than that in normal control group(163.05±22.74 vs 113.29±17.15 ng/L),serum contents of inflammatory factors such as IL-8,IL-11,IL-32 and TNF-αwere higher than those in normal control group(12.01±1.85 vs 9.73±1.64 pg/ml,16.19±1.84 vs 13.05±1.76 pg/ml,24.11±3.76 vs 20.73±3.41 pg/ml,7.61±0.89 vs 6.58±0.84 pg/ml),the difference was statistically signficant(t=6.902~29.915,all P=0.000),and changes of above indexes in HpSA positive patients of CAG group were greater than those in HpSA negative patients,the difference was statistically significant(t=19.134,11.826,9.163,10.426,6.371 and 5.571,all P=0.000).Conclusion Positive rate of HpSA in stool of CAG patients was significantly higher than that in normal gastric mucosa people.The gastrointestinal hormone secretion disorder was aggravated and systemic inflammatory response is more serious in CAG patients with HpSA positive stool.