血清胃蛋白酶原和抗HpIgG抗体对消化性溃疡的临床意义

doi:10.3969/j.issn.1673-8640.2014.11.011

摘要/Abstract

摘要：

目的　研究血清胃蛋白酶原(PG)和抗幽门螺杆菌(Hp)IgG抗体对消化性溃疡的临床价值。方法　选取2007年10月至2012年12月期间，在上海华东疗养院体检时发现的消化性溃疡115例作为溃疡组，其中胃溃疡65例，十二指肠溃疡50例。对照组为同期健康体检者，共90名，其中男女比例及年龄均与溃疡组匹配。采用胶乳增强免疫透射比浊法检测PGⅠ、PGⅡ，并计算两者比值(PGⅠ/PGⅡ，PGR)，利用酶联免疫吸附试验(ELISA)对受检者血清进行抗Hp IgG抗体检测。结果　溃疡组中，PGⅠ和PGⅡ水平分别为(180.14±20.56)和(24.98±10.14)ng/mL，PGR为7.87±1.29，PGⅠ、PGⅡ及PGR明显高于对照组(P＜0.05)。溃疡组和对照组抗Hp IgG抗体阳性率分别为77.4%和23.3%，差异具有统计学意义(P＜0.05)。Hp阳性组的PGⅠ与PGⅡ分别为(165.35±22.14)及(20.75±11.26)ng/mL，PGR为7.64±2.03，明显高于Hp阴性组(P＜0.05)。结论　异常血清PG和抗Hp IgG抗体与消化性溃疡密切相关，并且可以作为消化性溃疡早期的筛查指标。

关键词: 胃蛋白酶原, 抗幽门螺杆菌抗体, 消化性溃疡

Abstract:

Objective　 To investigate the clinical significance of serum pepsinogen (PG) and anti-Helicobacter pylori (Hp) IgG antibody in the diagnosis of peptic ulcer. Methods　A total of 115 peptic ulcer patients (peptic ulcer group) were found by attending physical examination from October 2007 to December 2012 in Huadong Sanatorium of Shanghai, including 65 cases of gastric ulcer and 50 cases of duodenal ulcer. A total of 90 healthy subjects were enrolled as controls, and the sex and age ratios were the same with those in peptic ulcer group. The levels of serum PGⅠ and PGⅡ were measured by latex-enhanced immunoturbidimetry, and the PGⅠ/Ⅱratio(PGR)was calculated. The serum anti-Hp IgG antibody was determined by enzyme-linked immunosorbent assay (ELISA). Results　In peptic ulcer group, the serum levels of PGⅠand PGⅡand PGR were (180.14±20.56) ng/mL, (24.98±10.14) ng/mL and 7.87±1.29, respectively, which were significantly higher than those in control group (P<0.05).The positive rate of anti-Hp IgG antibody infection in peptic ulcer group was 77.4%, and that in control group was 23.3%, with statistical significance(P<0.05).Serum PGⅠ and PG Ⅱlevels and PGR in HP positive group were (165.35±22.14) ng/mL, (20.75±11.26) ng/mL and 7.64±2.03, respectively, which were significantly higher than those in HP negative group (P<0.05). Conclusions　The serum PG and anti-Hp IgG antibody are related closely with peptic ulcer changes, and they can be used for the early screening of peptic ulcer.

Key words: Pepsinogen, Anti- IgG antibody, Peptic ulcer

中图分类号:

R446.62

赵兰静，刘春兴，安仙园. 血清胃蛋白酶原和抗HpIgG抗体对消化性溃疡的临床意义[J]. 检验医学, 2014, 29(11): 1124-1127.

ZHAO Lanjing, LIU Chunxing, AN Xianyuan.. Clinical significance of serum pepsinogen and anti-Hp IgG antibody in the diagnosis of peptic ulcer[J]. , 2014, 29(11): 1124-1127.

参考文献

[1] 季春玮,杨力. 幽门螺杆菌 oipA 基因与胃粘膜组织中IL-17表达的关系[J]. 解放军医学杂志,2011,36(3):228-230.
[2] 伍丽萍,赵锐,王一平. 序贯治疗幽门螺杆菌感染的Meta分析[J]. 解放军医学杂志,2010,35(9):1141-1144.
[3] Shafaghi A, Mansour-Ghanaei F, Joukar F, et al. Serum gastrin and the pepsinogen Ⅰ/Ⅱ ratio as markers for diagnosis of premalignant gastric lesions [J]. Asian Pac J Cancer Prev, 2013, 14(6):3931-3936.
[4] Toyoda K, Furusyo N, Ihara T, et al. Serum pepsinogen and Helicobacter pylori infection-a Japanese population study [J].Eur J Clin Microbiol Infect Dis, 2012, 31(9):2117-2124.
[5] Huang M, Tang AG, Mu S,, et al. Serum pepsinogen reference intervals in apparently healthy Chinese population with latex enhanced turbidimetric immunoassay[J].Clin Pathol, 2014, 67(4):350-354.
[6] 朱国民,邱峰. 三种血清胃蛋白酶原检测方法在胃癌筛查中的比较分析[J]. 检验医学,2012,27(11):961-962.
[7] 黄语嫣,叶建新,高楠,等. 幽门螺杆菌、血清胃蛋白酶原与慢性胃病及胃癌的关系[J]. 江苏医药,2013,39(5):528-530.
[8] 万佳蔚,胡仁静. 血清胃蛋白酶原对消化道溃疡的早期诊断价值[J]. 职业与健康,2012,28(23):2908-2909.
[9] 费凤英,王金金,祝新华,等. 血清胃蛋白酶原检测在胃部疾病诊断中的意义[J]. 检验医学,2012,27(1):57-59.
[10] 华嘉临,张艺,黄飚. 血清胃蛋白酶原检测诊断消化性溃疡的临床价值[J]. 山东医药,2010,50(37):16-17.
[11] 吴园园,李志.血清胃蛋白酶原检测对消化性溃疡的临床诊断价值[J].求医问药:下半月,2012,2(4):91-92.
[12] Watanabe M, Kato J, Inoue I, et al. Development of gastric cancer in nonatrophic stomach with highly active inflammation identified by serum levels of pepsinogen and Helicobacter pylori antibody together with endoscopic rugal hyperplastic gastritis[J].Int J Cancer, 2012, 131(11):2632-2642.
[13] 梁景云. 幽门螺杆菌抗体检测的临床意义[J]. 中国当代医药,2010,17(25):83.
[14] 张杰,王冬娥,米贤军,等. 消化性溃疡幽门螺杆菌(Hp)清除前后血Hp抗体、PG、GAS变化的研究[J]. 临床和实验医学杂志,2006,5(7):869-871.
[15] 孙丽萍,宫月华,王兰,等. 辽宁庄河地区居民血清胃蛋白酶原含量检测分析[J]. 中华消化杂志,2006,26(10):649-652.
[16] 赵素萍,汪欣,蔡梅玉,等. 胃蛋白酶原与幽门螺杆菌检测的相关性研究[J]. 检验医学与临床,2012,9(22):2868-2869.
[17] 陶伟,张宁,杨力. 慢性胃病及胃癌中幽门螺杆菌感染与血清胃蛋白酶原水平变化的关系[J]. 解放军医学杂志,2012,37(4):350-353.
[18] Suriani R, Venturini I, Colozza M, et al. Helicobacter pylori antibodies (CagA and VacA) detection. The link between cancer and infection[J].Minerva Gastroenterol Dietol, 2002, 48(2):1591-1564.
[19] Shiota S, Murakami K, Okimoto T, et al. Serum Helicobacter pylori CagA antibody titer as a useful marker for advanced inflammation in the stomach in Japan[J].J Gastroenterol Hepatol, 2014, 29(1):67-73.