血清胃蛋白酶原与胃泌素检测对慢性萎缩性胃炎的诊断价值

目的探讨血清胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ（PGⅠ/PGⅡ）比值（PGR）和胃泌素-17（G-17）与慢性萎缩性胃炎的关系,确定其在萎缩性胃炎中的变化规律。方法 选择在我院消化科行胃镜检查符合入选研究标准的300例患者,根据组织病理学诊断结果分为慢性非萎缩性胃炎组（202例）和慢性萎缩性胃炎组（98例）。采用酶联免疫吸附试验（ELISA）方法定量测定空腹血清PGⅠ、PGⅡ和G-17水平,并计算PGⅠ/PGⅡ比值（PGR）。采用14C-或13C-呼气试验和快速尿素酶试验两种方法联合判定幽门螺杆菌（Hp）感染情况。结果 慢性萎缩性胃炎组与非萎缩性胃炎组相比,血清PGⅠ分别为128.55±61.42μg/L和150.61±75.33μg/L,比较有显著差异（P〈0.05）。PGR分别为10.09±5.15和10.95±7.18,比较无显著差异（P〉0.05）;G-17分别为9.68±15.51pmol/L和18.93±18.92pmol/L,比较有显著差异（P〈0.05）。Hp阳性组PGR（8.96±7.72）与阴性组（11.63±5.56）比较有显著差异（P〈0.05）;Hp阳性组PGⅠ（125.39±65.90μg/L）与阴性组（154.19±65.13μg/L）比较有显著差异（P〈0.05）;Hp阳性组G-17（10.91±15.50pmol/L）与阴性组（10.68±19.12pmol/L）比较无显著差异（P〉0.05）。结论 联合检测血清PG和G-17水平可用于慢性萎缩性胃炎的筛查,如有异常,应进一步行胃镜检查以确诊并指导治疗。Hp感染与PG水平的变化有关。

Diagnosis Value of Chronic Atrophic Gastritis by Mesasuring Serum Pepsinogen and Gastrin

Objective To search the relationship between serum PGⅠ,PGⅠ/PGⅡ ration(PGR) and gastrin-17(G-17) and chronic atrophic gastritis and to establish the changes of serum PGⅠ,PGⅠ/PGⅡ ratio(PGR) and G-17 in patients with chronic atrophic gastrits.Methods 300 patients who underwent endoscopy were recruited according to the inclusion criteria.Based on histopathologic diagnosis criteria,these patients were divided into two groups:One was chronic non atrophic gastritis group(n=202),the other was chronic atrophic gastrits group(n=98).Fasting serum samples of PGⅠ,PGⅡ and G-17 determination were analyzed by enzyme-linked immunosorbent assay(ELISA);The ratio of PGⅠ/PGⅡ(PGR) was calculated.Infection of helicobacter pylori(Hp) was determined by 13C or 14C-urea expiration test and rapid urease test.Results In chronic atrophic gastritis group compared to those in the chronic non atrophic gastritis group,serum levels of PGⅠ(128.55±61.42 μg/L and 150.61±75.33 μg/L) was significantly decreased(P<0.05);PGR vlue(10.09±5.15 and 10.95±7.18) had no significantly decreas(P>0.05);G-17(9.68±15.51 pmol/L and 18.93±18.92 pmol/L) was significantly decreased(P<0.05).Hp positive group compared to those in the Hp negative group,serum level of PGⅠ(125.39±65.90 μg/L and 154.19±65.13 μg/L) was significantly decreased(P<0.05);serum level of PGR(8.96±7.22 and 11.63±5.66) was significantly decreas(P<0.05);serum level of G-17(10.91±15.50 poml/L and 10.68±19.12 pmol/L) had no signficantly decreas(P>0.05).Conclusion Detection of serum PG and G-17 levels can be used in the screening of chronic atrophic gastritis.If abnormal,endoscopy should be performed to make final diagnosis and guide the treatment.Hp infection is related to the change of PG level.