黎杨杨 林裕锋 陈冬玲

【摘要】 目的：探究肝硬化门脉高压性胃病（PHG）血清胃蛋白酶原（PG）的变化情况和意义。方法：选取2017年1月-2019年12月笔者所在医院收治的80例肝硬化患者作为研究对象，根据有无PHG分为PHG组（n=43）与非PHG组（n=37），并将同期笔者所在医院40例健康体检者作为对照组，检测三组受试者PG水平变化情况。结果：PHG组患者PGⅠ、PGR水平均低于非PHG组及对照组，差异均有统计学意义（P<0.05）;PHG组肝功能A级、C级患者均多于非PHG组，B级患者少于非PHG组，差异均有统计学意义（P<0.05）;对不同严重程度PHG患者血清PG予以检测，结果显示中重度组PGⅠ、PGⅡ及PGR水平均低于轻度组，差异均有统计学意义（P<0.05）。结论：血清PG在肝硬化门脉高压性胃病患者中呈现出低表达，能够反映出胃黏膜损伤程度，为临床诊断及治疗提供参考。

【关键词】 肝硬化 门脉高压性胃病 血清胃蛋白酶 肝功能分级 临床意义

doi：10.14033/j.cnki.cfmr.2020.20.019 文献标识码 B 文章编号 1674-6805（2020）20-00-03

Changes and Significance of Serum Pepsinogen in Patients with Portal Hypertensive Gastropathy Due to Cirrhosis/LI Yangyang， LIN Yufeng， CHEN Dongling. //Chinese and Foreign Medical Research， 2020， 18（20）： -52

[Abstract] Objective： To explore the changes and significance of serum pepsinogen （PG） in patients with portal hypertensive gastropathy （PHG） due to cirrhosis. Method： A total of 80 cirrhotic patients admitted to our hospital from January 2017 to December 2019 were selected as research objects. According to whether PHG was present， they were divided into the PHG group （n=43） and the non-PHG group （n=37）. Meanwhile， 40 healthy physical examinees in our hospital at the same time were taken as control group to detect the change of PG level in three groups. Result： The levels of PGⅠ and PGR in the PHG group were significantly lower than those in the non-PHG group and the control group， the differences were statistically significant （P<0.05）. The patients with grade A and C liver function in the PHG group were more than those in the non-PHG group， and patients with grade B were less than those in the non-PHG group， the differences were statistically significant （P<0.05）. The serum PG in PHG patients with different severity was detected， and the results showed that the PGⅠ， PGⅡ and PGR in the moderate and severe group were lower than those in the mild group， the differences were statistically significant （P<0.05）. Conclusion： Serum PG shows low expression in patients with portal hypertensive gastropathy due to cirrhosis， which can reflect the degree of gastric mucosa damage and provide reference for clinical diagnosis and treatment.

[Key words] Cirrhosis Portal hypertensive gastropathy Serum pepsin Liver function classification Clinical significance

First-authors address： Yangjiang Peoples Hospital， Yangjiang 529500， China

作為临床上特殊的独立胃病，门脉高压性胃病（PHG）主要指的是无明显炎症胃病但伴随黏膜或黏膜下血管扩张的病理现象，多发于肝硬化患者[1-2]。文献[3]报道，64%～70%肝硬化患者伴随PHG，是肝硬化患者发生消化道出血的主要因素，同时也在一定程度上增加了肝硬化患者的诊疗难度。作为胃蛋白酶的前体，胃蛋白酶原（PG）来源于胃体黏膜主细胞与黏液颈细胞，分为PGⅠ与PGⅡ两个亚群，会随着胃黏膜病变发生变化，可以将该指标作为胃黏膜病变的敏感性指标[4]。此次研究收集肝硬化病例80例，均为2017年1月-2019年12月笔者所在医院收治患者，现对研究结果予以如下汇报。

1 资料与方法

1.1 一般资料

选取2017年1月-2019年12月笔者所在医院收治的80例肝硬化患者进行分析。纳入标准：（1）所有患者经诊断及检查均确诊为肝硬化，PHG符合WHO相关标准[5-7];（2）患者临床资料及病史、检查记录等资料完善，检查前均告知患者。排除标准：（1）经诊断合并心肺功能不全或严重器质性病变;（2）神志不清或精神障碍;（3）合并原发性肝癌、慢性肾病;（4）近期接受过影响观察指标的相关治疗;（5）妊娠期及哺乳期妇女;（6）存在语言交流沟通障碍、听力障碍或无法配合研究[8]。……