胃黏膜病变患者血清胃蛋白酶原水平与幽门螺杆菌感染的关系

Relationship between Serum Pepsinogen Level and Helicobacter Pylori Infection in Patients with Gastric Mucosal Lesions

目的:探讨不同胃黏膜病变患者血清胃蛋白酶原(PG)水平与幽门螺杆菌(Hp)感染的关系。方法:选取2017年5月-2019年5月于福建省老年医院行胃镜检查的患者(n=783)为研究对象,分为慢性非萎缩性胃炎、慢性萎缩性胃炎、消化性溃疡、胃癌组,分别进行~(13)C-呼气试验和血清PGⅠ、PGⅡ检测,比较各胃黏膜病变组中Hp阴性与Hp阳性患者血清PG水平,并比较Hp阳性的不同胃黏膜病变组间血清PG水平。接着,Hp阳性患者进行标准四联抗Hp方案治疗,治疗后8周再次检测血清PG水平,并比较根除成功患者治疗前后血清PG水平。结果:不同胃黏膜病变组中Hp阳性患者血清PGⅠ、PGⅡ水平均高于Hp阴性患者,且Hp阳性的不同胃黏膜病变患者血清PGⅠ、PGⅡ水平差异有统计学意义(P<0.05)。而在成功根除Hp后,不同胃黏膜病变组中血清PGⅠ、PGⅡ水平均明显下降。结论:血清中PG浓度可以作为评估胃黏膜状态的有效手段;而Hp根除后血清PGⅠ和PGⅡ水平降低可能是抗Hp治疗效果评价的潜在指标。

Objective:To investigate the relationship between serum pepsinogen level and Helicobacter pylori infection in patients with different gastric mucosal lesions.Method:A total of 783 patients undergoing gastroscopy at the Geriatric Hospital of Fujian Province from May 2017 to May 2019 were divided into chronic non-atrophic gastritis,chronic atrophic gastritis,peptic ulcer and gastric cancer groups.13C-breath test and serum PGⅠ,PGⅡ were respectively detected.The serum PG levels of Hp-negative and Hp-positive patients in each gastric mucosal lesion group were compared,the serum PG levels of Hp positive patients with different gastric mucosal lesions were compared.Then,Hp positive patients were treated with standard quadruple anti-Hp regimen.Serum PG levels were measured again at 8 weeks after treatment and were compared before and after eradication.Result:The levels of PGⅠ and PGⅡ in Hp positive patients were higher than those in Hp negative patients,and there were significant differences in PGⅠ and PGⅡ in Hp positive patients with different gastric mucosal lesions (P<0.05).After Hp was successfully eradicated,serum PGⅠ and PGⅡ levels were significantly decreased in different gastric mucosal lesion groups.Conclusion:The PG concentration in serum can be used as an effective method to evaluate the gastric mucosal status,and the decrease of PGⅠ and PGⅡ levels after Hp eradication may be a potential index to evaluate the efficacy of anti-Hp therapy.