胃癌患者血清和胃液胃泌素,胃动素和亮—脑啡肽的研究

用放射免疫法测定胃病患者血清和胃液中胃泌素，胃动素和亮－脑啡肽的含量。结果与正常对照组和胃良性疾病比较，胃癌患者血清和胃液胃泌素、胃动素显著升高，血清亮－脑啡肽含量也升高。揭示测定胃液胃泌素、胃动素和血清亮－脑啡肽对胃癌诊断有一定参考价值。     

胃病患者血清胃液胃液素、胃动素和亮-脑啡肽的变化

目的 研究胃病患者血清胃液胃液素、胃动素和亮-脑啡肽的变化及临床意义。 方法 用放射免疫法测定胃病患者(胃癌25例、胃溃疡18例和萎缩性胃炎24例)血清胃液中胃液素、胃动素和亮-脑啡肽的含量。 结果 与正常对照和胃良性疾病比较,胃癌患者血清胃液胃液素、胃动素显著升高(P<0.01),血清亮-脑啡肽含量也升高(P<0.05)。 结论 胃癌患者血清胃液胃液素、胃动素和血清亮-脑啡肽可明显升高,对胃癌诊断有一定参考价值。     

食管癌患者血清胃液脑肠肽变化意义

目的研究食管癌患者血清胃液脑肠肽变化意义.方法用放射免疫法测定25例中晚期食管癌患者血清胃液中物质P(SP),β-内啡肽(β-EP),血管活性肠肽(VIP),胃动素(MTL),促胃液素(GT)和亮脑啡肽(LEK)含量,并以27例相当的正常人作对照.结果食管癌患者血清,胃液SP(pmol/L, 88.0±54.7 vs 38.7±20.9,P＜0.01;23.0±8.0 vs 18.2±7.3,P＜0.05) β-EP(ng/L, 61.7±26.4 vs 36.6±20.8,P＜0.01;51.7±16.1 vs 30.3±12.0,P＜0.01),胃液VIP(ng/L, 88.1±14.3 vs 65.9±19.8,P＜0.01), MTL(ng/L, 204.9±42.7 vs 153.5±27.2,P＜0.01), LEK(ng/L, 55.5±15 vs 31.8±11.6,P＜0.01)含量显著高于正常人,而血清胃液GT(ng/L, 36.5±23.1 vs 61.0±22.5,P＜0.01;1.9±1.0 vs 3.4±2.0,P＜0.01)含量则显著低于正常人,且血清胃液SP,β-EP升高和GT降低呈正相关(P＜0.05).结论晚期食管癌患者血清胃液上述肽类物质可发生变化,且存在一定相关性,联合测定血清胃液这些物质对研究食管癌时脑肠肽类变化有一定意义.     

萎缩性胃炎患者血清胃液脑肠肽的研究

目的研究萎缩性胃炎伴肠化和（或）异型增生患者血清胃液中部分脑肠肽的变化及临床意义．方法用放射免疫法测定３５例萎缩性胃炎患者血清胃液中物质Ｐ（ＳＰ），β内啡肽（βＥＰ），血管活性肠肽（ＶＩＰ），胃动素（ＭＴＬ），胃液素（ＧＴ）和亮脑啡肽（ＬＥＫ）含量，并以３３例相当的正常人作对照．结果萎缩性胃炎患者血清胃液ＳＰ，βＥＰ，胃液ＶＩＰ，ＭＴＬ，ＬＥＫ含量显著高于正常人（Ｐ＜００１），而血清胃液ＧＴ含量则显著低于正常人（Ｐ＜００１），且血清胃液ＳＰ，βＥＰ升高和ＧＴ降低呈正相关（Ｐ＜００５）．萎缩性胃炎伴肠化和（或）异生和ＣＡＧ部位之间，上述物质无明显差异．１２例患者伴有轻度贫血（Ｈｂ：１０１６ｇ／Ｌ±１６５ｇ／Ｌ）．结论萎缩性胃炎患者血清胃液脑肠肽可发生变化，且存在一定相关性，联合测定血清胃液这些物质对研究萎缩性胃炎时脑肠肽变化有一定意义．     

血清和胃液PⅢNP、LN在胃癌辅助诊断中的价值

目的:探讨胃液、血清中层黏连蛋白(laminin,LN)、Ⅲ型前胶原氨端(N-terminal procollagenⅢpeptide,PⅢNP)含量的检测在胃癌辅助诊断中的价值.方法:采用放射免疫法测定50例胃癌患者、25例癌前病变患者胃液和血清中PⅢNP和LN含量,以46例浅表性胃炎患者作为对照.结果:胃癌组患者胃液中PⅢNP含量显著高于癌前病变组和对照组(40.49μg/L±39.07μg/L vs8.49μg/L±5.45μg/L,7.38μg/L±6.13μg/L,均P<0.01),LN的水平也显著高于癌前病变组和对照组(131.61ng/mL±55.71ng/mL vs90.92ng/mL±58.36ng/mL,80.65ng/mL±59.43ng/mL,P<0.05;P<0.01);胃癌组血清中PⅢNP含量明显高于癌前病变组和对照组(55.38μg/L±25.13μg/L vs41.56μg/L±18.27μg/L,39.89μg/L±13.07μg/L,均P<0.05),LN的水平亦显著高于对照组(158.62ng/mL±42.70ng/mL vs126.25ng/mL±36.18ng/mL,P<0.01).胃液PⅢNP和LN单独检测对胃癌诊断的敏感性分别为68.00%、66.00%,二者联合检测其敏感性为86.00%.进一步分析显示,伴有淋巴结或器官转移的患者胃液和血清中PⅢNP和LN水平高于不伴有转移的患者;PⅢNP和LN水平与病理分级相关,低分化腺癌患者胃液、血清中PⅢNP和LN含量高于高分化腺癌患者.结论:胃液及血清PⅢNP和LN含量的检测在胃癌的辅助诊断中有一定临床价值.     

胃癌患者不同术式术后血清胃泌素、神经降压素和胃动素的变化

目的　检测胃癌术后不同手术方式对血清胃泌素、胃动素和神经降压素的影响。方法　应用放射免疫法测定了胃癌患者远端胃切除、近端胃切除和全胃切除后血清胃泌素、血浆胃动素和神经降压素的含量。结果　近端胃切除患者血清胃泌素明显高于远端胃切除组和全胃切除组 (P <0 0 5 ) ,而三组间血浆神经降压素、胃动素无明显差异。三组不同术式胃切除后患者血浆神经降压素均明显低于正常值 (P <0 0 1)。结论　胃癌不同手术方式术后血清胃泌素含量不同 ,而对血浆胃动素与神经降压素浓度无明显影响     

木霉菌醇对胃癌大鼠肿瘤抑制作用及对MrP4、胃肠道功能的影响

目的 探讨木霉菌醇对胃癌大鼠肿瘤的抑制作用及对MrP4、胃肠道功能的影响。方法 将40只健康大鼠随机分为健康组、胃癌组、木霉菌醇组(给予木霉菌醇40 mg/kg灌胃)、白藜芦醇组(给予白藜芦醇50 mg/kg灌胃),每组10只，采用生存状态积分评定各组大鼠生存状态；酶联免疫法检测各组大鼠胃泌素、胃动素水平；检测各组大鼠肿瘤体积及肿瘤生长抑制率；HE染色检测大鼠胃癌组织形态；TUNEL法检测大鼠胃癌组织细胞凋亡情况；免疫组化检测MrP4表达。结果 与健康组大鼠相比，在药物干预5 d、10 d、15 d及21 d各个时间点胃癌组大鼠生存状态分数、血清中胃动素和胃泌素的水平均降低，胃癌组织中MrP4的阳性表达率明显上升(P<0.05);与胃癌组相比，在药物干预后各时间点木霉菌醇组和白藜芦组大鼠生存状态分数、血清中胃动素、胃泌素的水平及胃癌组织的细胞凋亡率均显著升高，大鼠瘤体体积及胃癌组织中MrP4的阳性表达率降低(P<0.05);白藜芦组大鼠生存状态分数、血清中胃动素、胃泌素的水平及胃癌组织的细胞凋亡率均高于木霉菌醇组，大鼠瘤体体积及胃癌组织中MrP4的阳性表达率低于木霉菌醇组(...     

肠易激综合征患者胃运动功能与胃肠激素和心理因素的关系

目的探讨肠易激综合征(IBS)患者胃运动功能与胃肠激素、心理因素之间的关系。方法测定36例腹泻型IBS、44例便秘型IBS患者和35例正常对照者胃固体排空功能,记录胃电节律变化,测定空腹血液中一氧化氮(NO)、胃泌素(GAS)和胃动素(MTL)水平,采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和症状自评量表(SCL-90)进行心理因素评分。结果便秘型IBS患者胃固体排空时间延长,腹泻型IBS患者胃固体排空时间缩短。IBS患者存在显著的胃电节律紊乱。腹泻型IBS患者血清一氧化氮含量显著降低(P<0.05),但血浆胃动素、血清胃泌素含量显著增高(P<0.05);便秘型IBS患者血清一氧化氮、胃泌素含量显著增高(P<0.05),但血浆胃动素含量显著降低(P<0.05)。IBS患者普遍存在抑郁、焦虑、恐怖、强迫观念和人际关系敏感等异常心理,以焦虑和抑郁更为突出。结论IBS患者存在胃固体排空障碍及胃电节律紊乱,两者间有一定的关系;IBS患者存在血液胃动素、胃泌素和一氧化氮水平的改变;IBS患者存在明显的心理异常。     

传染病和寄生虫病

20020001病毒性肝炎患者血胃动素、胃泌素检测的临床意义/陶华兴…刀实用医学杂志一2001,17(8)一701~702 结果示:血浆胃动索(MTL)含量均值为正常组(30例)>急性肝炎组(3o例)>慢性肝炎组(25例)>重型肝炎组;血清胃泌素(GSR)含量均数为正常组>慢性肝炎组>急性肝炎组>重型肝炎组。且     

肝硬化患者胃液腹水胃动素水平测定的临床意义

目的:探讨胃液中胃动素的存在,腹水及血浆胃动素测定对肝硬化患者的临床意义。方法:以非平衡放射免疫法对45例肝硬化失代偿期患者进行胃液、腹水及血浆胃动素的检测。结果:胃液与腹水胃动素分别为246.22±50.34及395.32±54.22,与血浆胃动素水平、总胆红素、血肌酐及腹水量均呈正相关(各P<0.01);与血清白蛋白呈负相关(P<0.05)。按Child分级,C级组胃液、腹水胃动素较A、B级显著升高(P<0.01),提示胃液、腹水胃动素的高低与肝功能状况呈显著正相关。结论:胃液中不但存在胃动素,而且与腹水、血浆胃动素同步显著升高,此胃动素水平,对肝硬化的诊断具一定参考价值。     

慢性胃病中几种胃肠激素水平的改变和意义

本文用RIA法测定352例胃镜病理诊断的胃十二指肠病患者之胃液,血清表皮生长因子（EGF），生长抑素（SS）和胃泌素（GAS）水平。结果表明，胃液EGF水平在胃癌明显升高，在消化性溃疡降低；血清SS及GAS水平在各种胃十二指肠病中均显著高于正常对照，溃疡病的血清SS和GAS水平呈负相关趋势。各种胃病血清SS水平相近，胃液SS水平胃癌显著高于良性胃病，且胃癌胃液SS显著高于其血清SS水平。幽门螺杆菌（HP）感染不影响溃疡病的血清GAS和SS水平及慢性浅表性胃炎的血清SS水平，HP感染严重时慢性萎缩性胃炎的血清SS水平显著升高。     

胃十二指肠疾病与血浆激素关系的初步研究

对64例胃十二指肠疾病患者(包括慢性残表性胃炎23例,萎缩性胃炎5例,胃溃疡10例,十二指肠溃疡14例及胃癌12例)的血浆生长抑索(SS)、血管活性肠肽(VIP)、胃动素(MTL)及血清胃泌素(Gas)的研究表明,血浆SS水平在胃十二指肠溃疡组及胃癌组均低于正常对照组(P<0.001);血浆VIP浓度在胃溃疡时升高最明显,与正常组及各疾病组比较均有显著性差异(P<0.01);十二指肠溃疡及胃癌组的血浆MTL含量均高于正常对照组(P<0.05);血清Gas水平在浅表性胃炎和萎缩性胃炎时均高于正常对照组(P<0.01).     

胃液中可溶性上皮型钙粘蛋白在几种胃疾病中的表达及其临床意义

目的探讨胃液中可溶性上皮钙粘蛋白(sE-cad)在检测几种胃部疾病中的诊断价值。方法113例因胃肠道症状接受胃镜检查配合活检确诊为慢性萎缩性胃炎16例,胃粘膜肠上皮化生20例,胃溃疡34例,胃癌22例,21例轻度浅表性胃炎(和无任何病理改变者作为正常对照组)。用双抗夹心酶联免疫吸附法检测胃液中sE-cad水平。结果胃癌组胃液sE-cad水平升高,与对照组比较差异有统计学意义(P<0.01);慢性萎缩性胃炎组及胃粘膜肠上皮化生组胃液sE-cad水平升高,与对照组比较差异有统计学意义(P<0.05)。结论胃液sE-cad水平升高可能对胃癌的诊断提供一定的佐证。     

Gastric juice nitrite and vitamin C in patients with gastric cancer and atrophic gastritis: is low acidity solely responsible for cancer risk?

BACKGROUND: N-nitroso compounds are carcinogens formed from nitrite, a process that is inhibited by vitamin C in gastric juice. Helicobacter pylori infection has been reported to increase nitrite and decrease vitamin C in gastric juice. Therefore, susceptibility to gastric cancer in H. pylori-infected patients may be derived from increased N-nitroso compounds in gastric juice. However, most H. pylori-infected patients do not develop gastric cancer. OBJECTIVE: To investigate additional factors that may affect susceptibility to gastric cancer, we compared nitrite and vitamin C levels in gastric juice from H. pylori-infected patients with and without gastric cancer. METHODS: Serum and gastric juice were obtained from 95 patients undergoing diagnostic endoscopy, including those with normal findings, duodenal ulcer, gastric ulcer, atrophic gastritis and gastric cancer. Serum was analysed for H. pylori antibody, nitrate and nitrite, gastrin and pepsinogens; gastric juice was analysed for pH, nitrite and vitamin C. RESULTS: pH and nitrite levels were increased and vitamin C levels decreased in the gastric juice of patients with atrophic gastritis and gastric cancer compared with other patients. However, in patients with a similar gastric acidity (pH 5-8), nitrite concentrations in the gastric juice were significantly higher and vitamin C levels significantly lower in patients with gastric cancer than in those with atrophic gastritis. CONCLUSION: Although hypochlorhydria increases intraluminal nitrite and decreases intraluminal vitamin C, which increases the intraluminal formation of N-nitroso compounds, our results indicate that patients with gastric cancer may have additional factors that emphasize these changes.     

Effect of Helicobacter pylori Infection on Gastric Juice pH

Background: How Helicobacter pylori infection affects gastric acid secretion is still unclear. Methods: Gastric juice pH, ammonia concentration in gastric juice, serum gastrin level, and grade of gastritis in accordance with the Sydney System were determined for patients with gastric ulcer (GU) and duodenal ulcer (DU) before and after treatment with lansoprazole and amoxicillin, and results were compared with those of H. pylori-negative controls. Results: Scores for H. pylori density, atrophy, metaplasia, and activity of gastritis in the corpus were higher in patients with GU, especially those with proximally located GU, than in those with DU. Gastric juice pH was significantly higher in GU patients than in DU patients and controls. After H. pylori eradication, gastric juice pH and serum gastrin levels in both GU and DU patients were significantly decreased to control levels. In patients without eradication, no significant changes in these factors were observed. Conclusions: These findings suggest that H. pylori infection and gastritis in the corpus suppress acid secretion and increase gastric juice pH, resulting in hypergastrinemia, and that eradication of H. pylori normalizes acid secretion and serum gastrin levels.     

Gastric juice ammonia vs CLO test for diagnosis ofHelicobacter pylori infection

The aim of the present study was to compare the gastric juice ammonia test to the CLO test for the diagnosis ofH. pylori infection in culture-proven cases by receiver operating characteristic (ROC) curve analysis. We studied 75 subjects (44 with chronic gastritis, 10 with gastric ulcer, 6 with duodenal ulcer, 8 with gastric cancer, and 7 normal) by endoscopy with biopsy for tissue diagnosis, culture ofH. pylori. CLO test, and by gastric juice ammonia determinations. The culture-positive group had significantly higher intragastric ammonia levels (13.7±5.8 mg/dl) than the negative group (4.9±2.4 mg/dl,P<0.01). In ROC curve analysis, the gastric juice ammonia test showed higher true positive and lower false positive ratios than the CLO test (P<0.05). In conclusion, the measurement of intragastric juice ammonia levels was considered to be simpler, quicker, and overall a more valuable method for diagnosingH. pylori infection.     

经内镜胃液pH值侧定诊断慢性萎缩性胃炎402例的价值

本文报告402例慢性胃炎患者经内镜胃液pH值测定结果,探讨胃液pH值对慢性萎缩性胃炎(CAG)的诊断价值。结果显示:CAG胃液pH值显著高于慢性浅表性胃炎(CSG,P<0.01),在CAG中随着萎缩程度加重,其胃液pH值逐渐增高(P均<0.01),CAG伴肠上皮化生或不典型增生者,其胃液pH值高于单纯CAG患者。结论:胃液pH值测定较内镜直视观察诊断符合率为高,其敏感性、特异性、阴性预测值强,故胃液pH值测定对提高CAG的诊断具有参考价值。     

Screening of atrophic gastritis and gastric cancer by serum pepsinogen, gastrin-17 and Helicobacter pylori immunoglobulin G antibodies

OBJECTIVE: Currently the screening and diagnosis of gastric cancer and atrophic gastritis are mainly made by endoscopy and biopsy. The aim of this study was to evaluate the use of serum tests: serum pepsinogen I (PGI pepsinogen I/II ratio (PGR), gastrin‐17 (G‐17) and H. pylori‐immunoglobulin G (IgG) antibodies to screen atrophic gastritis and gastric cancer. METHODS: A total of 458 patients were recruited, and each underwent endoscopy with biopsies before the serum tests were performed. These patients were divided into five groups based on the endoscopic and histological findings: 92 patients in the atrophic gastritis group, 58 in the gastric ulcer group, 90 in the duodenal ulcer group, 141 in the gastric cancer group (40 early gastric cancer and 101 advanced gastric cancer) and 77 (including mild non‐atrophic gastritis) served as a control group. Serum samples for PGI and II, G‐17, and H. pylori‐IgG antibodies estimation were analyzed by ELISA. RESULTS: PGI and PGR values decreased significantly both in atrophic gastritis and gastric cancer groups (P < 0.01). For the best discrimination of atrophic gastritis, the cut‐off values of PGI and PGR were 82.3 µg/L and 6.05, respectively. The PGI, PGR and G‐17 values were related significantly with the grades and/or sites of atrophic gastritis (P < 0.01). Patients with atrophic corpus gastritis had low PGI and PGR values and high G‐17 level, and patients with atrophic antral gastritis had low G‐17 level. G‐17 increased significantly in the gastric cancer group (P < 0.01). PGI and PGR values were significantly lower in patients with advanced gastric cancer than in patients with early gastric cancer, while there was no difference in G‐17 level between them. The positivity rate of H. pylori‐IgG antibodies was 54.55% in the control group. The PGI level was higher in H. pylori positive patients than in H. pylori negative ones (P < 0.001), while there was no difference in G‐17 level between them. The positivity rates of H. pylori‐IgG antibodies were over 85% in all other four groups. CONCLUSIONS: Low serum PGI, PGR and G‐17 values are biomarkers of atrophic antral gastritis. Atrophic corpus gastritis can be screened by lower serum PGI, PGR and high G‐17 values. [Correction added after online publication on 2 February 2007: the preceding sentence has replaced one that read ‘Atrophic be screened by serum PGI and PGR values’]. Gastric cancer can be screened on the basis of increased serum G‐17 and remarkedly low serum PGI and PGR values. The H. pylori infection is related to the change of PG level.     

治萎防变胶囊对气虚血瘀型CAG大鼠PGE2、GAS和血浆/胃组织MOT水平的影响

目的 探讨治萎防变胶囊对气虚血瘀型萎缩性胃炎(CAG)大鼠胃组织PGE2、血清胃泌素(GAS)和血浆/胃组织胃动素(MOT)水平的影响.方法 采用综合法复制CAG动物模型.施药治疗后分别对各组大鼠血清胃组织PGE2、血清GAS和血浆/胃组织MOT含量进行检测.结果 与空白组比较,模型组大鼠胃组织PGE2、血清GAS水平显著下降(P<0.01,P<0.05),血浆/胃组织MOT水平显著升高(P<0.05);与模型组比较,治萎防变胶囊可显著提高组织PGE2、血清GAS含量(P<0.05),显著降低血浆/胃组织MOT水平(P<0.05),且以治萎防变胶囊大剂量组作用显著.结论 治萎防变胶囊具有调节胃酸、胃黏膜黏液分泌,调整胃动力,增加胃黏膜血流量,改善微循环,营养和修复胃黏膜的作用.