高原农牧区成年人血清胃蛋白酶原水平与胃黏膜病变关系的研究

目的：探讨高原农牧区成年人血清胃蛋白酶原（PG）水平与胃黏膜病变的关系。方法：利用日立7170S型全自动生化分析仪，采用速率法测定血清PG水平，与内镜活检和病理形态学观察结果相结合，对比分析青海高原农牧区733名接受胃镜检查的成年人血清PGⅠ、PGⅡ水平和PGⅠ／PGll值与胃黏膜病变的关系。结果：胃黏膜基本正常（NOR）组血清PGⅠ、PGⅡ和PGⅠ／PGll值的中位数分别为87．7ng／mL、14．8ng／mL和6．0ng／mL。PGI在慢性浅表性胃炎（CSG）、慢性萎缩性胃炎（CAG）、肠上皮化生或异型增生（IM／Dys）和胃癌（GC）组明显低于NOR组（P均〈0．01），而。崛和IM／Dys组之间无差别两者，PU组明显高于其它胃黏膜病变组而又低于NOR组；PGⅡ在CSG、CAG、IM／Dys和GC组明显低于NOR组（P〈0．05或0．01），CSG、CAG和IM／Dys组明显低于PU组（P〈0．05或0．01），而3组之间无差别两者，CAG组又明显低于GC组（P〈0．01），NOR和PU组之间、PU与GC组之间无差别两者；PGⅠ／PGⅡ值在CAG、IM／Dys和GC组明显低于NOR、CSG和PU组（P均〈O．01），IM／Dys和GC组又明显低于CAG组（P均〈0．01）；NOR、CSG和PU组之间及CSG与CAG组之间无差别两者。结论：高原农牧区成年人血清PG水平与有无胃黏膜病变及胃黏膜病变的程度密切相关。表现为随着胃黏膜病变的逐级加重，血清PGⅠ水平和PGⅠ／PGⅡ值逐渐降低，而PGⅡ虽有降低现象，但无规律可循。利用血清PGⅠ水平和PGⅠ／PGⅡ值筛查高原地区胃癌前病变和胃癌较为合适。

The Relationship between Serum Pepsinogen Levels and Gastric Mucosal Lesion in Adults in Agricultural and Pastoral Areas at High Altitude

Objective：To study the relationship between serum pepsinogen （PG） level and gastric mucosal lesion in adults at high altitude. Methods. A total of 733 adults who received the gastroscopy examination were enrolled in this study. The serum PG levels of all cases were measured by the rate method using Hitachi 7 170S type automatic biochemical analyzer, and the relation of PGⅠ/PGⅡ ratio with gastric mucosal lesion was analyzed combining biopsy and pathological observations. Results. Serum PGⅠ, PGⅡ and the PGⅠ/PGⅡ median values were 87. 7 ng / mL, 14. 8 ng / mL and 6.0 respectively in the normal gastric mucosa group （NOR group）. Level of PGI was significantly lower in patients with chronic superficial gastritis （CSG）, chronic atrophic gastritis （CAG）, intestinal metaplasia or dysplasia （IM / Dys） and gastric cancer （GC） was significantly lower than the NOR group （P〈0.01）, but no difference between CAG and IM/Dys group, and level of PGⅡ was significantly lower in IM/Dys and GC group than that in CAG group （P〈0. 01）. Conclusions. The serum PG is related closely to occurrence of gastric mucosal lesion in adults in agriculture and pastoral area at high altitude. Level of PGI and PGⅠ/PGⅡ ratio were lower following severity of gastric mucosal lesion.