胃功能指标和幽门螺杆菌抗体阳性率与胃溃疡的关系

Relationship between gastric function indicators and positive rate of Helicobacter pylori antibody and gastric ulcer

目的探讨胃功能指标和幽门螺杆菌抗体(Hp-Ab)阳性率与胃溃疡的相关性。方法选择2017年1月—2021年12月无锡市锡山人民医院鹅湖分院经胃镜检查确诊的54例胃溃疡患者作为胃溃疡组,回顾并分析所有患者的临床资料;另外选择同期42名经胃镜检查无胃部疾病者作为对照组。采用荧光免疫层析定量试剂盒检测所有受检者血清胃蛋白酶原(PGⅠ和PGⅡ)、胃泌素-17(G-17),计算PGⅠ与PGⅡ比值(PGR),采用C-尿素呼气试验诊断试剂盒检测Hp-Ab阳性率。比较两组上述指标的差异以及各指标单独与联合检测的阳性率,采用Spearman相关分析方法对上述指标与胃溃疡发病进行相关性分析。结果胃溃疡组患者血清PGⅠ、PGⅡ、G-17水平和Hp-Ab阳性率均明显高于对照组,PGR明显低于对照组〔PGⅠ(μg/L):90.31±18.74比81.44±15.36,PGⅡ(μg/L):15.96±2.78比11.72±2.17,G-17(pmol/L):12.19±3.14比8.83±2.67,Hp-Ab阳性率:51.85%(28/54)比14.29%(6/42),PGR:5.87±1.82比8.05±1.96,均P<0.05〕;胃溃疡组血清PGⅠ、PGⅡ、PGR、G-17、Hp-Ab单独及联合检测的阳性率均明显高于对照组〔PGⅠ阳性率:29.63%(16/54)比11.90%(5/42),PGⅡ阳性率:12.96%(7/54)比0.00%(0/42),PGR阳性率:11.11%(6/54)比0.00%(0/42),G-17阳性率:57.41%(31/54)比4.76%(2/42),Hp-Ab阳性率:51.85%(28/54)比14.29%(6/42),联合检测阳性率:18.52%(10/54)比0.00%(0/42),均P<0.05〕;血清PGⅠ、PGⅡ、PGR、G-17、Hp-Ab均与胃溃疡发病显著相关(r值分别为0.568、0.804、0.671、0.451、0.683,P值分别为0.010、0.000、0.007、0.009、0.003)。结论胃溃疡患者的血清PGⅠ、PGⅡ、PGR、G-17水平和Hp-Ab阳性率与健康人群比较存在显著差异,血清学检测在胃溃疡的疾病诊断中有较高的应用价值。

Objective To explore the correlation between the gastric function indicators and positive rate of Helicobacter pylori antibody(Hp-Ab)and gastric ulcer.Methods The 54 patients with gastric ulcer diagnosed by gastroscopy admitted to Xishan People’s Hospital of Wuxi City from January 2017 to December 2021 were selected as gastric ulcer group,and the clinical data of all patients were reviewed and analyzed.Other42 subjects examined without gastric disease by gastroscopy during the same period were selected as control group.All subjects were detected for serum pepsinogen(PGⅠand PGⅡ)and gastrin-17(G-17),and the ratio of PGⅠto PGⅡ(PGR)was calculated.The positive rate of Hp-Ab was detected byC urea breath test diagnostic kit.The differences of above indexes between two groups and the positive rates of each index detected separately and jointly were compared.Spearman correlation analysis method was used to analyze the correlation between the above indexes and the incidence of gastric ulcer.Results The levels of serum PGⅠ,PGⅡ,G-17 and positive rate of Hp-Ab in gastric ulcer group were higher than those in control group,and the PGR level was lower than that in control group[PGⅠ(μg/L):90.31±18.74 vs.81.44±15.36,PGⅡ(μg/L):15.96±2.78 vs.11.72±2.17,G-17(pmol/L):12.19±3.14 vs.8.83±2.67,positive rate of Hp-Ab:51.85%(28/54)vs.14.29%(6/42),PGR:5.87±1.82 vs.8.05±1.96,all P<0.05].The positive rates of serum PGⅠ,PGⅡ,PGR,G-17,Hp-Ab alone and combined detection in gastric ulcer group were higher than those in control group[PGⅠ:29.63%(16/54)vs.11.90%(5/42),PGⅡ:12.96%(7/54)vs.0.00%(0/42),PGR:11.11%(6/54)vs.0.00%(0/42),G-17:57.41%(31/54)vs.4.76%(2/42),Hp-Ab:51.85%(28/54)vs.14.29%(6/42),combined detection:18.52%(10/54)vs.0.00%(0/42),allP<0.05].The serum PGⅠ,PGⅡ,PGR,G-17 and Hp-Ab were significantly correlated with gastric ulcer disease(r values were 0.568,0.804,0.671,0.451 and 0.683,respectively,and P values were 0.010,0.000,0.007,0.009 and 0.003,respectively).Conclusions The positive rates of serum PGⅠ,PGⅡ,PGR,G-17 and Hp-Ab in patients with gastric ulcer are significantly different from those in healthy people.Serological test has high application value in the diagnosis of gastric ulcer.