血清PG、G-17、IL-10在不同菌型Hp感染慢性非萎缩性胃炎中的表达及对预后评估的价值分析

The expression of serum PG,G-17 and IL-10 in chronic non-atrophic gastritis infected by different bacterial strains of Hp and its prognostic value

目的分析血清胃蛋白酶原(PG)、胃泌素-17(G-17)、白细胞介素-10(IL-10)在不同菌型幽门螺杆菌(Hp)感染慢性非萎缩性胃炎中的表达及对预后评估的价值。方法164例Hp阳性的慢性非萎缩性胃炎患者,均进行Hp抗体分型检测,抽取患者清晨空腹静脉血,检测血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ与PGⅡ的比值(PGR)、G-17、IL-10水平。分析Hp抗体分型检测结果,对比不同菌型Hp感染患者血清PGⅠ、PGⅡ、PGR、G-17、IL-10水平,不同预后患者血清PGⅠ、PGⅡ、PGR、G-17、IL-10水平。结果164例慢性非萎缩性胃炎患者中,Ⅰ型Hp感染125例,占比76.22%;Ⅱ型Hp感染39例,占比23.78%。Ⅱ型Hp感染患者的PGⅠ(83.69±14.30)μg/L、PGR(18.01±3.18)均高于Ⅰ型Hp感染患者的(66.25±15.51)μg/L、(12.18±2.01),PGⅡ(10.58±2.02)μg/L低于Ⅰ型Hp感染患者的(12.95±2.32)μg/L,差异有统计学意义(P<0.05)。Ⅱ型Hp感染患者IL-10(39.54±3.16)pg/ml高于Ⅰ型Hp感染患者的(35.11±4.23)pg/ml,差异有统计学意义(P<0.05);Ⅰ型、Ⅱ型Hp感染患者G-17水平比较,差异无统计学意义(P>0.05)。持续对患者随访1年,164例患者预后良好134例、预后不良30例。预后不良患者PGⅠ(50.20±11.98)μg/L、PGR(10.12±2.11)低于预后良好患者的(80.30±15.30)μg/L、(19.21±2.03),PGⅡ(14.38±2.30)μg/L高于预后良好患者的(9.69±2.01)μg/L,差异有统计学意义(P<0.05)。预后不良患者G-17(14.92±3.02)pmol/L、IL-10(33.10±4.25)pg/ml明显低于预后良好患者的(18.60±2.55)pmol/L、(40.20±3.18)pg/ml,差异有统计学意义(P<0.05)。结论慢性非萎缩性胃炎患者中Ⅰ型Hp感染较为多见,Ⅰ型与Ⅱ型Hp感染患者G-17水平表达基本一致,但Ⅰ型Hp感染患者的胃黏膜抗炎免疫机制更低,更易发展为胃癌,且PGⅠ、PGⅡ、PGR、G-17、IL-10水平表达情况与患者预后直接相关,可作为评估患者预后情况的有效指标。

Objective To analyze the expression of serum pepsinogen(PG),gastrin-17(G-17)and interleukin-10(IL-10)in chronic non-atrophic gastritis infected by different bacterial strains of Helicobacter pylori(Hp)and its prognostic value.Methods There were 164 patients with Hp-positive chronic non-atrophic gastritis,and all received Hp antibody typing test.Fasting venous blood samples were collected in the morning to detect serum pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),PGⅠ/PGⅡ ratio(PGR),G-17 and IL-10 levels.The results of Hp antibody typing test was analyzed,and the serum levels of PGⅠ,PGⅡ,PGR,G-17 and IL-10 in patients infected with different strains of Hp were compared,as well as the serum levels of PGⅠ,PGⅡ,PGR,G-17 and IL-10 in patients with different prognosis.Results Among 164 patients with chronic non-atrophic gastritis,125 patients were infected with type Ⅰ Hp,accounting for 76.22%,and 39 patients were infected with type Ⅱ Hp,accounting for 23.78%.The PGⅠ of(83.69±14.30)μg/L and PGR of(18.01±3.18)in patients with type Ⅱ Hp infection were higher than those of(66.25±15.51)μg/L and (12.18±2.01)in patients with type Ⅰ Hp infection;PGⅡ of(10.58±2.02)μg/L in patients with type Ⅱ Hp infection was lower than that of(12.95±2.32)μg/L in patients with type Ⅰ Hp infection;the differences were statistically significant(P<0.05).IL-10 of(39.54±3.16)pg/ml in patients with type Ⅱ Hp infection was higher than that of(35.11±4.23)pg/ml in patients with type Ⅰ Hp infection,and the difference was statistically significant(P<0.05).There was no statistically significant difference in G-17 level between type Ⅰ and type Ⅱ Hp infection patients(P>0.05).The patients were followed up for 1 year,and 134 of 164 patients had a good prognosis and 30 had a poor prognosis.PGⅠof(50.20±11.98)μg/L and PGR of(10.12±2.11)in patients with poor prognosis were lower than those of(80.30±15.30)μg/L and(19.21±2.03)in patients with good prognosis;PGⅡ of(14.38±2.30)μg/L in patients with poor prognosis was higher than that of(9.69±2.01)μg/L in patients with good prognosis;the differences were statistically significant(P<0.05).G-17 of(14.92±3.02)pmol/L and IL-10 of(33.10±4.25)pg/ml in patients with poor prognosis were significantly lower than those of(18.60±2.55)pmol/L and(40.20±3.18)pg/ml in patients with good prognosis,and the differences were statistically significant(P<0.05).Conclusion Type Ⅰ Hp infection is more common in patients with chronic non-atrophic gastritis.The expression of gastrin 17 in patients with type Ⅰ and type Ⅱ Hp infection is basically the same,but the anti-inflammatory and immune mechanism of gastric mucosa in patients with type Ⅰ Hp infection is lower,and they are more likely to develop into gastric cancer.The expression of PGⅠ,PGⅡ,PGR,G-17,IL-10 levels is directly related to the prognosis of patients,and can be used as an effective indicator to evaluate the prognosis of patients.