胃功能4项检查对消化性溃疡病情及病程的评估价值

The value of four indexes of gastric function in assessing the condition and course of peptic ulcer

目的 评价和分析胃功能4项检查对临床评估消化性溃疡病情及病程的价值。方法 选取120例消化性溃疡患者作为消化性溃疡组,其中活动期(A期)患者47例、愈合期(H期)患者52例、瘢痕期(S期)患者21例,其中病程≥3年患者53例和病程<3年患者67例;另选取49例同期进行体检的体健者作为体健组。所有研究对象均采用酶联免疫吸附试验检测胃泌素17以及胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ),采用碳13尿素呼气试验法检测幽门螺杆菌(Hp)阳性情况。比较消化性溃疡组与体健组Hp阳性率、胃泌素17、PGⅠ、PGⅡ、PGⅠ/PGⅡ检查结果,不同分期(A期、H期、S期)、不同病程患者的胃功能4项检查结果;分析消化性溃疡患者病程与胃功能4项检查结果的相关性。结果 消化性溃疡组患者的Hp阳性率80.83%、胃泌素17(38.48±6.81)pmol/L、PGⅠ(248.64±40.35)μg/L、PGⅡ(21.80±5.94)μg/L均显著高于体健组的6.12%、(13.50±2.73)pmol/L、(139.57±20.34)μg/L、(7.07±2.10)μg/L,PGⅠ/PGⅡ(10.48±5.12)低于体健组的(23.77±8.41),差异均有统计学意义(P<0.05)。A期患者的Hp阳性率及胃泌素17、PGⅠ、PGⅡ水平均明显高于H期及S期患者,PGⅠ/PGⅡ低于H期及S期患者,差异均有统计学意义(P<0.05)。H期患者Hp阳性率及胃泌素17、PGⅠ、PGⅡ水平均明显高于S期,PGⅠ/PGⅡ低于S期,差异均有统计学意义(P<0.05)。病程≥3年患者的Hp阳性率90.57%和胃泌素17(42.35±8.32)pmol/L、PGⅠ(265.35±45.23)μg/L、PGⅡ(27.24±8.15)μg/L均高于病程<3年患者的73.13%、(35.41±6.45)pmol/L、(235.42±32.25)μg/L、(17.50±4.81)μg/L,PGⅠ/PGⅡ(7.24±4.65)低于病程<3年患者的(13.04±7.01),差异均有统计学意义(P<0.05)。消化性溃疡患者的病程与Hp阳性率、胃泌素17、PGⅠ及PGⅡ呈正相关(r=0.395、0.394、0.457、0.681,P<0.05),与PGⅠ/PGⅡ呈负相关(r=-0.757,P<0.05)。结论 胃功能4项检查结果与消化性溃疡病情及病程存在关系,能够为临床评估病情严重程度及病程提供参考。

Objective To evaluate and analyze the value of four indexes of gastric function in assessing the condition and course of peptic ulcer.Methods 120 peptic ulcer patients were selected as the peptic ulcer group,of which 47 patients in the active stage(stage A),52 patients in the healing stage(stage H),and 21 patients in the scar stage(stage S),including 53 patients with disease course ≥3 years and 67 patients with disease course <3 years;another 49 healthy fit individuals who underwent physical examination at the same time were selected as the healthy group.All subjects were tested for gastrin 17,pepsinogen Ⅰ(PG Ⅰ),and pepsinogen Ⅱ(PG Ⅱ)by enzyme-linked immunosorbent assay,and the Helicobacter pylori(Hp) was detected by carbon-13 urea breath test.Comparison was made on results of Hp positive rate,gastrin 17,PGⅠ,PGⅡ,PGⅠ/PGⅡ between the peptic ulcer group and the healthy group,the results of the four indexes of gastric function in patients with different stages(stage A,stage H,stage S) and patients with different disease courses.The correlation between the disease course and the results of the four indexes of gastric function in patients with peptic ulcer was analyzed.Results The peptic ulcer group had Hp-positive rate of 80.83%,gastrin 17 of(38.48±6.81) pmol/L,PGⅠ of(248.64±40.35) μg/L,and PG Ⅱ of(21.80±5.94) μg/L,which were significantly higher than 6.12%,(13.50±2.73) pmol/L,(139.57±20.34) μg/L,and(7.07±2.10) μg/L in the healthy group;the PGⅠ/PGⅡ(10.48±5.12) in the peptic ulcer group was lower than(23.77±8.41) in the healthy group;the differences were all statistically significant(P<0.05).The Hp-positive rate and the levels of gastrin 17,PGⅠ and PGⅡ in stage A patients were significantly higher than those in stage H and S patients,and PGⅠ/PGⅡ was lower than that in stage H and S patients,and the differences were statistically significant(P<0.05).The Hp-positive rate and gastrin 17,PGⅠ and PGⅡ levels in stage H patients were significantly higher than those in stage S patients,and the PGⅠ/PGⅡ was lower than that in stage S patients.The differences were statistically significant(P<0.05).Patients with disease course ≥3 years had Hp-positive rate of 90.57% and gastrin 17 of(42.35±8.32) pmol/L,PGⅠ of(265.35±45.23) μg/L and PGⅡof(27.24±8.15) μg/L,which were higher than 73.13%,(35.41±6.45) pmol/L,(235.42±(32.25) μg/L,(17.50±4.81) μg/L in patients with disease course <3 years;the PG Ⅰ/PG Ⅱ(7.24±4.65) of patients with disease course≥3 years was lower than(13.04±7.01) in patients with disease course <3 years;the differences were statistically significant(P<0.05).The disease course in patients with peptic ulcer was positively correlated with Hp-positive rate,gastrin 17,PGⅠ and PGⅡ(r=0.395,0.394,0.457,0.681;P<0.05) and negatively correlated with PGⅠ/PGⅡ(r=-0.757,P<0.05).Conclusion The results of the four indexes of gastric function are related to the condition and course of peptic ulcer and can provide a reference for clinical assessment of the severity and course of the disease.