肝硬化合并门脉高压性胃病患者血清胃蛋白酶原变化及临床意义

摘要

目的 探讨肝硬化合并门脉高压性胃病(Portal Hypertension Gastropathy,PHG)患者血清胃蛋白酶原变化及临床意义.方法 选择2015年1月至2016年1月本院住院治疗的122例肝硬化患者作为研究对象,根据胃镜下检查有无PHG,分为肝硬化合并PHG组62例和肝硬化无PHG组60例;同期选择在本院进行健康体检人群60例作为对照组.肝功能进行根据Child-Pugh评分分级为A级、B级、C级,检测血清胃蛋白酶原(Pepsinogen,PG)水平,并计算PG Ⅰ/PGⅡ比值(PGR),分析血清PG水平与胃黏膜病变的关系.结果 肝硬化PHG组肝功能明显低于无PHG组(x 2=6.588,P=0.037);PHG组较无PHG组血清PG Ⅰ水平显著降低(t=7.378,P=0.000);重度胃黏膜病变患者血清PG Ⅰ、PGR水平较轻度患者明显降低(t=2.392、4.292,P=0.009、0.000);肝硬化病变不同部位各组血清PG水平比较,差异无统计学意义(t=1.803、2.632、0.658,P=0.174、0.080,0.522).结论 肝硬化合并门脉高压性胃病患者血清PG Ⅰ水平显著降低,可反映肝硬化胃黏膜受损程度,对评价胃黏膜功能状态具有一定价值.%Objective To investigate the change in serum pepsinogen (PG) of patients with liver cirrhosis and portal hypertensive gastropathy (PHG) and its clinical significance.Methods 122 cases of liver cirrhosis treated in our hospital from January 2015 to January 2016 were selected,and divided into liver cirrhosis with PHG group (62 cases) and liver cirrhosis without PHG group (60 cases) according to endoscopic check result.Another 60 healthy people in our hospital during the same period were selected as control group.Liver function was graded as A,B,C grade according to Child-Pugh score.Checked the level of serum PG,and calculated the ratio of PG Ⅰ /PG Ⅱ (PGR),analyzed the relationship between the level of serum PG and gastric mucosal lesion.Results The level of liver function of liver cirrhosis with PHG group was significantly lower than that of liver cirrhosis without PHG group (x 2=6.588,P=0.037).The level of serum PG Ⅰ of liver cirrhosis with PHG group was significantly lower than that of liver cirrhosis without PHG group (t=7.378,P=0.000).The levels of serum PG Ⅰ,PGR of patients with severe gastric mucosal lesions were significantly lower than those of patients with mild gastric mucosal lesions (r=2.392,4.292;P=0.009,0.000).There were no statistically significant differences in the level of serum PG among patients with different parts of liver cirrhosis lesions (t=1.803,2.632,0.658;P=0.174,0.080,0.522).Conclusion The level of serum PG Ⅰ of patients with liver cirrhosis and portal hypertensive gastropathy is significantly lower than that of healthy people,which can reflect the extent of gastric mucosal lesion of liver cirrhosis,and has a certain value to evaluate the functional state of gastric mucosa.