胃蛋白酶原等指标测定在胃部疾病的应用价值(1)
[摘要] 目的 通过测定血浆胃泌素17( G-17)、胃蛋白酶原Ⅰ( PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、和H.pylori IgG (Hp)抗体来探讨其在胃部疾病中的联合诊断价值。 方法 整群选取2014年8月—2015年12月在南平市第一医院216例住院患者，根据胃镜和组织病理学检查结果将受检者分为胃癌组( 74例) 、慢性萎缩性胃炎组(22例)、慢性浅表性胃炎组(70例)、正常对照组(50例)。每一例均用酶联免疫吸附试验( ELISA )定量测定空腹血浆PGⅠ、PGⅡ和G17水平， 定性测定H.pylori IgG抗体。 结果 ①PGⅠ、PGⅡ和G-17水平在慢性浅表性胃炎[(176.50±128.55)μg/L、17.77±15.75)μg/L、(12.54±16.39)pmol/L]明显高于正常组[(107.78±25.48)μg/L、(8.13±2.79)μg/L、(4.34±3.33)pmol/L]和胃癌组[(79.59±83.37)μg/L、(9.42±10.83)μg/L、(5.20±9.91)pmol/L]，组间t检验差异有统计学意义(P<0.01)；②PGR (PGⅠ/ PGⅡ比值)水平在慢性浅表性胃炎(12.90±6.50)高于慢性萎缩性胃炎(9.29±5.80)，差异有统计学意义(P<0.05)；③PGⅠ水平在胃癌(79.59±83.37)μg/L明显低于正常组(107.78±25.48)μg/L，组间t检验差异有统计学意义(P<0.01)。PGⅠ和PGⅡ水平在胃癌[(79.59±83.37)μg/L、(9.42±10.83)μg/L]低于慢性萎缩性胃炎[(165.40±144.77)μg/L、(23.40±28.89)μg/L]，差异有统计学意义(P<0.05)。 结论 血浆PGⅠ、PGⅡ与胃黏膜炎性病变密切相关，可作为慢性浅表性胃炎初步筛查和动态疗效评价的重要辅助诊断手段；PGR可用于慢性萎缩性胃炎的筛查；PGⅠ水平显著低下可做胃镜进行胃癌筛查， 有助于提高胃癌的早期诊断率。
[关键词] 胃蛋白酶原；H.pylori IgG 抗体；慢性浅表性胃炎；慢性萎缩性胃炎；胃癌
[中图分类号] R573 [文献标识码] A [文章编号] 1674-0742(2016)06(a)-0012-05
[Abstract] Objective To explore the diagnostic value that the various gastric diseases can be screened non- endoscopically by plasma tests： pepsinogen (PGⅠ)Ⅰ， PGⅡ， gastrin-17 ( G-17) and H. pylori-IgG(Hp) antibodies. Methods A total of 216 patients，suffered from gastric diseases from August 2014 to December 2015 were collected. These patients were further divided into three groups based on endoscopic and histological findings 74 gastric cancer group ，22 atrophic gastritis group，70 superficial gastritis group and 50 normal group. plasma samples of PGⅠ and PGⅡ， G-17， H.pylori -IgG antibodies were analyzed by enzyme -linked immunosorbent assay (ELISA). Results ①PGⅠ、PGⅡand PGR values were significantly decreased in gastric cancer group[(79.59±83.37)μg/L、(9.42±10.83)μg/L、(5.20±9.91)μg/L]and normal group[(107.78±25.48)μg/L、(8.13± 2.791)μg/L、(4.34±3.33)μg/L]as compared with those in superficial gastritis group. T test between two groups had significant difference(P<0.01)② PGR value was decreased in atrophic gastritis group (9.29±5.80)μg/Las compared with those in superficial gastritis(12.90±6.50)μg/L，the difference had statistical significance(P<0.05). PGⅠvalue were significantly decreased in gastric cancer group(79.59±83.37)μg/L，T test between two groups had significant difference(P<0.01)； ③PGⅠand PGⅡvalue was decreased in gastric cancer group[(79.59±83.37)μg/L、(9.42±10.83)μg/L]as compared with those in atrophic gastritis group[(165.40±144.77)μg/L、23.40±28.89)μg/L]，the difference had statistical significance(P<0.05). Conclusion plasma PGⅠ、PGⅡis associated with gastric mucosal inflammatory lesions and can be used as a preliminary screening of chronic superficial gastritis andauxiliary diagnosis method of dynamic curative effect evaluation .The detection of plasma PGR value can be useful to screen atrophic gastritis group， Based on markedly decreased plasma PG I gastric cancer can be screened and dia -gnosed endoscopically and histologically. (吴志耘 艾玉梅)
[关键词] 胃蛋白酶原；H.pylori IgG 抗体；慢性浅表性胃炎；慢性萎缩性胃炎；胃癌
[中图分类号] R573 [文献标识码] A [文章编号] 1674-0742(2016)06(a)-0012-05
[Abstract] Objective To explore the diagnostic value that the various gastric diseases can be screened non- endoscopically by plasma tests： pepsinogen (PGⅠ)Ⅰ， PGⅡ， gastrin-17 ( G-17) and H. pylori-IgG(Hp) antibodies. Methods A total of 216 patients，suffered from gastric diseases from August 2014 to December 2015 were collected. These patients were further divided into three groups based on endoscopic and histological findings 74 gastric cancer group ，22 atrophic gastritis group，70 superficial gastritis group and 50 normal group. plasma samples of PGⅠ and PGⅡ， G-17， H.pylori -IgG antibodies were analyzed by enzyme -linked immunosorbent assay (ELISA). Results ①PGⅠ、PGⅡand PGR values were significantly decreased in gastric cancer group[(79.59±83.37)μg/L、(9.42±10.83)μg/L、(5.20±9.91)μg/L]and normal group[(107.78±25.48)μg/L、(8.13± 2.791)μg/L、(4.34±3.33)μg/L]as compared with those in superficial gastritis group. T test between two groups had significant difference(P<0.01)② PGR value was decreased in atrophic gastritis group (9.29±5.80)μg/Las compared with those in superficial gastritis(12.90±6.50)μg/L，the difference had statistical significance(P<0.05). PGⅠvalue were significantly decreased in gastric cancer group(79.59±83.37)μg/L，T test between two groups had significant difference(P<0.01)； ③PGⅠand PGⅡvalue was decreased in gastric cancer group[(79.59±83.37)μg/L、(9.42±10.83)μg/L]as compared with those in atrophic gastritis group[(165.40±144.77)μg/L、23.40±28.89)μg/L]，the difference had statistical significance(P<0.05). Conclusion plasma PGⅠ、PGⅡis associated with gastric mucosal inflammatory lesions and can be used as a preliminary screening of chronic superficial gastritis andauxiliary diagnosis method of dynamic curative effect evaluation .The detection of plasma PGR value can be useful to screen atrophic gastritis group， Based on markedly decreased plasma PG I gastric cancer can be screened and dia -gnosed endoscopically and histologically. (吴志耘 艾玉梅)