标题：血清胃蛋白酶原水平与慢性胃炎的相关性

      作者：孙运涛，冯亮源，谭静，曹晓哲    中山市东凤人民医院检验科，广东 中山 528425

      卷次： 2019年30卷16期

      【摘要】 目的 探讨血清胃蛋白酶原水平与慢性胃炎的相关性，为患者提供临床指导。方法 选择2018年3月至2019年3月在中山市东凤人民医院就诊的慢性浅表性胃炎患者30例，慢性萎缩性胃炎轻度、中度和重度患者各20例作为研究对象，以30例体检健康人群作为对照组。检测并比较各组受检者血清中胃蛋白酶原Ⅰ(PGI)、胃蛋白酶原Ⅱ (PGII)、PGⅠ/PGⅡ比值和幽门螺旋杆菌(Hp)，并判断Hp感染与PGⅠ、PGⅡ和PGⅠ/PGⅡ之间的关系。结果 慢性浅表性胃炎组患者的PGⅠ和PGⅡ水平分别为(58.27±16.27) ng/mL、(11.47±3.78) ng/mL，明显低于对照组的(90.33±21.14) ng/mL和(21.36±3.89) ng/mL，PGⅠ/PGⅡ的比值为 5.36±1.52，明显高于对照组的 4.43±3.11，差异均有统计学意义(P<0.05)；重度萎缩性胃炎组患者的PGⅠ和PGⅠ/PGⅡ比值分别为(26.41±10.53) ng/mL和(0.72±0.44)，明显低于中度患者的(37.51±18.79) ng/mL和(1.25±0.71)，PGⅡ水平为(33.41±1.77) ng/mL，明显高于中度患者的(28.89±2.02) ng/mL，而中度萎缩性胃炎患者的 PGⅠ和 PGⅠ/PGⅡ明显低于轻度患者的(65.37±15.89) ng/mL和(2.55±1.24)，PGⅡ为(28.89±2.02) ng/mL，明显高于轻度患者的(26.69±2.21) ng/mL，差异均有统计学意义(P<0.05)；Logistic回归分析结果显示，PGⅠ和PG/PGⅡ进入回归方程，Wald值检验有统计学意义(P<0.05)；Hp感染者和未感染者之间的PGⅠ和PGⅡ水平比较差异无统计学意义(P>0.05)，但Hp感染者的PGⅠ/PGⅡ为9.28±4.91，明显低于未感染者的11.81±5.81，差异有统计学意义(P<0.05)。结论 血清胃蛋白酶原Ⅰ、Ⅱ的检测水平和PGⅠ/PGⅡ比值变化，提示PGⅠ和PGⅡ明显高于健康人，可以用于筛查或者诊断大批量人群的慢性胃炎，值得临床推广。
      【关键词】 慢性胃炎；慢性萎缩性胃炎；血清胃蛋白酶原；胃蛋白酶原Ⅰ；胃蛋白酶原Ⅱ；相关性
      【中图分类号】 R573.3 【文献标识码】 A 【文章编号】 1003—6350（2019）16—2061—03

Correlation between serum pepsinogen detection and chronic gastritis.
SUN Yun-tao, FENG Liang-yuan, TAN Jing,CAO Xiao-zhe. Department of Clinical Laboratory, Dongfeng People's Hospital of Zhongshan, Zhongshan 528425,Guangdong, CHINA
【Abstract】 Objective To explore the correlation between serum pepsinogen detection and chronic gastritis,and to provide clinical guidance for patients. Methods Thirty patients with chronic superficial gastritis and twenty pa-tients of patients with mild, moderate and severe chronic atrophic gastritis each, who admitted to Dongfeng People's Hos-pital of Zhongshan from March 2018 to March 2019, were selected as the study group. Thirty healthy people for physicalexamination were selected as the control group. The serum pepsinogenⅠ(PGⅠ), pepsinogenⅡ (PGⅡ), PGⅠ/PGⅡ de-tection and Helicobacter pylori (Hp) of the groups were detected and compared, and the relationship between Hp infectionand PGⅠ, PGⅡ and PGⅠ/PGⅡ were evaluated. Results The levels of PGI and PGⅡ in the patients with chronic su-perficial gastritis were (58.27±16.27) ng/mL and (11.47±3.78) ng/mL, respectively, which were significantly lower thancorresponding (90.33±21.14) ng/mL and (21.36±3.89) ng/mL in the control group; the levels of PGⅠ/PGⅡ was 5.36±1.52, which was significantly higher than 4.43±3.11 in the control group (all P<0.05). The levels of PGI and PGⅠ/PGⅡin the patients with severe atrophic gastritis were (26.41±10.53) ng/mL and 0.72±0.44, which were significantly lower thancorresponding (37.51±18.79) ng/mL and 1.25±0.71 in the moderate patients; the level of PGⅡ was (33.41±1.77) ng/mL,which was significantly higher than (28.89±2.02) ng/mL in the moderate atrophic gastritis; while the levels of PGⅠ andPGⅠ/PGⅡ in the patients with moderate atrophic gastritis were (37.51±18.79) ng/mL and 1.25±0.71, which were signifi-cantly lower than corresponding (65.37±15.89) ng/mL and 2.55±1.24 in the mild patients; the level of PGⅡ was (28.89±2.02) ng/mL, which was significantly higher than (26.69±2.21) ng/mL in the mild patients (all P<0.05). Logistic regressionanalysis showed that PGⅠ and PGⅠ/PGⅡ were statistically significant in the Wald test and the validity of the regressionequation was statistically significant by the χ 2 test (P<0.05). There was no significant difference in PGⅠ and PGⅡ be-tween Hp-infected and non-infected patients (P>0.05). PGⅠ/PGⅡ in Hp-infected patients was 9.28±4.91, which was sig-nificantly lower than 11.81±5.81 in uninfected patients (P<0.05). Conclusion The levels of serum pepsinogenⅠ andⅡand the changes of PGⅠ/PGⅡ ratio suggest that the levels of PGⅠ and PGⅡ are significantly higher than those ofhealthy people and can be used to screen and diagnose chronic gastritis in large populations, which is worthy of clinicalpromotion.
      【Key words】 Chronic gastritis; Chronic atrophic gastritis; Serum pepsinogen; Pepsinogen Ⅰ; Pepsinogen Ⅱ;Correlation