血清胃蛋白酶原检测在慢性萎缩性胃炎筛查中的价值

摘要

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)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200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(135例)和慢性萎缩性胃炎组(65例).采用化学发光方法定量测定空腹血清PG Ⅰ、PGⅡ,并计算PGⅠ /PGⅡ比值(PGR).结果 慢性萎缩性胃炎组与非萎缩性胃炎组血清PGⅠ分别为(78.55±15.42)μg/L和(130.51±55.23)μg/L,有显著差异(P＜0.05).PGR分别为4.09±2.15和8.95±5.18,显著差异(P＜0.05)；以PG Ⅰ≤70 μg/L且PGR≤3.0为界值来计算诊断慢性萎缩性胃炎的敏感性和特异性分别为72.3％和93.3％.结论 检测血清PG及PGR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.%Objective To discuss the relationship of 9erum PG I , PG I /PG II ratio (PGR) with chronic atrophic gastritis and to find the change law in chronic atrophic gastritis. Methods Two hundred patients who underwent endos-copy were recruited according to the inclusion criteria. Based on histopathologic diagnosis criteria, these patients were divided into two groups: non-chronic atrophic gastritis group (n = 135) , chronic atrophic gastritis group (n =65). Serum levels of PG I and PGR were assayed by immunoradiometic assay. Results The serum levels of PG I were (78.55 ± 15.42) μg/L and (130.51 ±55.23)μg/L respectively in chronic atrophic gastritis group and non-chronic atrophic gastritis group, there was significant difference. The serum levels of PGR were 4.09 ± 2. 15 and 8.95±5.18 respectively in chronic atrophic gastritis group and non-chronic atrophic gastritis group, there was also significant difference. The sensitivity and specificity were 72.3% and 93.3% in screening chronic atrophic gastritis on the cut-off values of PG I ≤70 μg/L and PGR≤3.0. Conclusion Detection of serum PG and PGR 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.