郑梅英

[摘要] 目的 分析檢测血清胃蛋白酶原在胃相关疾病诊断当中的应用效果。方法 方便选取2018年4月—2019年4月该院收治的胃病患者60例作为胃病组，选同期健康体检人员60名作为健康组，对两组受试人员均进行血清胃蛋白酶原检测，对两组受试人员均进行血清胃蛋白酶原检测，采集两组受试人员清晨空腹静脉血5 mL，将血清分离之后，对血清指标进行迅速冷冻，将标本放置在-20℃的冰箱当中待测。胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ含量的检测使用相应的配套试剂盒，通过自动化学发光免疫检测仪器实施测定。观察两组人员的血清检测结果。 结果 胃病组患者不同的胃黏膜病变患者血清胃蛋白酶原检测值测定结果进行观察，和慢性非萎缩性胃炎相比，慢性萎缩性胃炎与胃溃疡患者血清胃蛋白酶原Ⅰ、血清胃蛋白酶原Ⅱ比值相对有所降低，胃癌患者血清胃蛋白酶原Ⅰ、血清胃蛋白酶原Ⅱ比值显著降低。并且与健康组人员比较，数据差异有统计意义（P<0.05）。健康组PGI、PGⅡ、PGⅠ/ PGⅡ比值分别是（160.9±4.8）μg/L、（20.1±2.0）μg/L、（8.9±2.4）μg/L，慢性非萎缩性胃炎分别是（180.8±2.0）μg/L、（30.2±1.0）μg/L、（6.4±2.0）μg/L，和健康组比较，差异有统计学意义（t=21.73、26.03、4.91），慢性萎缩性胃炎分别是（150.2±2.1）μg/L、（30.0±1.0）μg/L、（5.2±2.1）μg/L，和健康组比较（t=11.64、18.53、5.46），胃溃疡（120.9±1.9）μg/L、（30.3±1.0）μg/L、（4.3±1.9）μg/L，和健康组比较（t=25.88、19.09、5.76），胃癌分别是（90.6±3.6）μg/L、（30.1±2.0）μg/L、（3.6±1.8）μg/L，和健康组比较（t=31.91、10.74、4.81），差异有统计学意义（P<0.05）。结论 血清蛋白酶原的变化情况和胃粘膜的病变密切相关，有助于胃癌前病变与胃癌的早期筛查，具备重要的临床价值。

[关键词] 血清;胃蛋白酶原;胃黏膜;临床价值

[中图分类号] R573          [文献标识码] A          [文章编号] 1674-0742（2020）03（a）-0177-03

Application of Serum Pepsinogen （PG） in the Diagnosis of Gastric-related Diseases

ZHENG Mei-ying

Department of Gastroenterology， Shishi Hospital， Shishi， Fujian Province， 326700 China

[Abstract] Objective To analyze the application of serum pepsinogen in the diagnosis of gastric-related diseases. Methods 60 patients with gastric disease admitted in the hospital from April 2018 to April 2019 were convenient selected as the gastric disease group， and 60 patients with health examinations were selected as the healthy group during the same period. Serum pepsinogen test was performed on both groups of subjects. All subjects in the two groups were tested for serum pepsinogen， and 5 ml of fasting venous blood in the morning was collected from the two groups of subjects. After the serum was separated， the serum indicators were quickly frozen， and the specimens were placed in a refrigerator at -20 degrees Celsius for testing. The detection of pepsinogen Ⅰ and pepsinogen Ⅱ content was carried out by using the corresponding kits and automated chemiluminescence immunodetection equipment. Observe the serum test results of the two groups. Results Compared with chronic non-atrophic gastritis， the ratio of serum pepsinogen Ⅰ and serum pepsinogen Ⅱ in patients with chronic atrophic gastritis compared with chronic non-atrophic gastritis was observed， relatively lower， the ratio of serum pepsinogen Ⅰ and serum pepsinogen Ⅱ in gastric cancer patients decreased significantly. And the difference between the data and the health group was statistically significant （P<0.05）. The PGI， PGⅡ， and PGⅠ/PGⅡ ratios in the healthy group were （160.9±4.8）μg/L， （20.1±2.0）μg/L， and （8.9±2.4）μg/L， respectively， and chronic non-atrophic gastritis were （180.8±2.0）μg/L， （30.2±1.0）μg/L， and （6.4±2.0）μg/L， compared with the healthy group（t=21.73，26.03， 4.91）， chronic atrophic gastritis were （150.2±2.1）μg/L， （30.0±1.0）μg/L， （5.2±2.1）μg/L， compared with the healthy group（t=11.64， 18.53， 5.46）， and gastric ulcer （120.9±1.9）μg/L， （30.3±1.0）μg/L， （4.3±1.9）μg/L， compared with the healthy group（t=25.88， 19.09， 5.76）， gastric cancer were （90.6±3.6）μg/L，（30.1±2.0）μg/L，（3.6±1.8）μg/L， compared with the healthy group （t=31.91， 10.74， 4.81），and the difference was statistically significant（P<0.05）. Conclusion The change of serum proteogen is closely related to the lesions of gastric mucosa， which is helpful for the early screening of gastric precancerous lesions and gastric cancer and has important clinical value.

[Key words] Serum; Pepsinogen; Gastric mucosa; Clinical value

胃部疾病属于临床较为常见的疾病，常见的疾病类型主要有急慢性胃炎、胃溃疡及胃癌等等。通常胃癌疾病被发现多是晚期，70%以上的早期胃癌没有明显的症状，胃癌疾病检查的手段通常是胃镜检查。相关研究显示[1]，血清胃蛋白酶原指标检测对于胃癌早期具备诊断效果。胃蛋白酶原属于胃液当中胃蛋白酶无活性前体，胃蛋白酶原没有活性，并且在胃内盐酸的作用之下，或是通过酸性条件，经过自身的催化，由N端水解42个氨基酸之后，再转变成具备活性胃蛋白酶[2]。……