血清胃蛋白酶原对肝硬化患者胃黏膜功能的评估价值

摘要

Objective To investigate the value of serum pepsinogen (PG) levels in the assessment of gastric mucosa function in patients with cirrhosis. Methods A total of 110 patients of cirrhosis confirmed by endoscopy were enrolled in the study. The liver function was classified by child-pugh grading. According to gastroscopy results, the patients were divided into liver cirrhosis with portal hypertensive gastropathy group (PHG group, 46 cases) and liv-er cirrhosis without PHG group (non-PHG group, 64 cases). Fifty health people for physical examination in our hospi-tal were selected as control group. The serum levels of PG (PGⅠ, PGⅡ) in all the participants were tested by latex-en-hanced immunoturbidimetry to calculate the PG/PGⅡratio (PGR). The relationships between serum PGⅠ, PGⅡlev-els and gastric mucosal lesions were analyzed. Results The liver function of PHG group was poorer than that of non-PHG group (P<0.05). Compared with non-PHG group and control group, serum PGⅠlevels of PHG group was sig-nificantly lower (P<0.05), and the difference of PGⅡand PGR was not statistically significant. Compared with patients with mild gastric mucosal lesions, serum PGⅠlevels of patients with severe gastric mucosal lesions was lower, and the difference was statistically significant (P<0.05). Conclusion The serum level of PGI decreases signifiantly in patients with hepatic cirrhosis and PHG. The more serious the injury of gastric mucosal is, the lower the level of se-rum PG would be. Serum PG level, especially PGⅠ, can reflect the function of gastric mucosa in patients of liver cirrhosis.%目的：探讨血清胃蛋白酶原(PG)水平对肝硬化患者胃黏膜功能的评估价值。方法选取我院胃镜检查已确诊的110例肝硬化患者，采用Child-Pugh对肝功能进行分级，根据肝硬化患者胃镜下检查有无门脉高压胃病(PHG)，分为肝硬化合并PHG组46例和肝硬化无PHG组64例，选取同期在我院进行健康体检人群50例作为正常对照组。检测所有受试者的血清PG (PGⅠ、PGⅡ)浓度，计算PGⅠ/PGⅡ值(PGR)，分析血清PGⅠ、PGⅡ水平和胃粘膜病变的关系。结果与肝硬化无PHG组比较，肝硬化合并PHG组肝功能较差，差异有统计学意义(P<0.05)；与肝硬化无PHG组和对照组比较，肝硬化合并PHG组血清PGⅠ水平明显降低，差异均有统计学意义(P<0.05)，而PGⅡ、PGR水平比较差异则无统计学意义(P>0.05)。与轻度胃黏膜病变患者比较，重度胃粘膜病变患者血清PGⅠ的水平更低，差异有统计学意义(P<0.05)。结论肝硬化合并PHG时血清PGⅠ水平明显降低，胃黏膜损伤越严重，血清PG的水平越低；血清PG水平尤其PGⅠ对肝硬化胃黏膜功能状态有一定的评估价值。