肝硬化患者血清胃蛋白酶原水平与肝硬化门脉高压胃病严重程度相关性分析
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摘要
目的观察肝硬化患者血清胃蛋白酶原(PG)水平,分析血清PG水平与肝硬化门脉高压胃病(PHG)严重程度相关性。方法选取2015年6月至2018年3月在本院接受治疗的试验组肝硬化患者110例,其中肝炎肝硬化77例,酒精性硬化18例,自身免疫性肝硬化9例,原发性胆汁淤积性肝硬化6例。对照组为健康体检者20名。全部参与对象检查胃黏膜状态诊断PHG,其中肝硬化不合并PHG组59例为试验1组,肝硬化合并轻度PHG 31例为试验2组,肝硬化合并重度PHG 20例为试验3组。检测试验组、对照组及不同类别硬化病例血清中PGⅠ、PGⅡ的含量,进行数据分析比对。结果对照组血清PGⅠ水平(183±62)μg/L均高于试验1组(160±53)μg/L、试验2组(82±34)μg/L、试验3组(85±35)μg/L(P<0.05);试验1组血清PGⅠ水平高于试验2组、试验3组(P<0.05);试验1组PGⅡ水平(17±5)μg/L和对照组血清中PGⅡ(23±6)μg/L水平均高于试验2组(13±4)μg/L、试验3组(12±4)μg/L(P<0.05);对照组血清中PGⅡ水平高于试验2组(P>0.05);试验1组、试验2组、试验3组中PGⅠ、PGⅡ值中位数值递减;不同病因肝硬化患者血清中PG水平比较差异无统计学意义。结论血清PGⅠ和PGⅡ能较好地评估胃黏膜分泌功能,可初步预测肝硬化PHG的形成,依据两者含量水平对不同病程的PHG进行评估和临床治疗。
Objective To observe the serum pepsinogen(PG) level in patients with liver cirrhosis and to analyze the correlation between the serum PG level and severity of cirrhosis portal hypertensive gastropathy(PHG). Methods The experimental group consisted 110 patients with liver cirrhosis treated in our hospital from June 2015 to March2018, including 77 cases of liver cirrhosis,18 cases of alcoholic liver cirrhosis,9 cases of autoimmune cirrhosis and 6cases of primary biliary cirrhosis. The control group consisted of 20 healthy subjects. All participants participated in the diagnosis of gastric mucosal PHG. Among them, 59 cases of cirrhosis without PHG were treated as experimental group 1, 31 cases of cirrhosis with mild PHG as experimental group 2, 20 cases of cirrhosis with severe PHG as experimental group 3. The serum levels of PG I and PGⅡ in the experimental group, the control group and different kinds of sclerosis cases were detected. The data were analyzed and compared. Results The serum PG I levels in the control group(183±62)μg/L were higher than those in the experimental group 1(160 ±53)μg/L, experimental group 2(82±34)μg/L, experimental group 3(85±35)μg/L, respectively(P<0.05); the serum PG I levels in the experimental group 1 were higher than those of the experimental group 2 and experimental group 3, respectively(P<0.05); the serum PGⅡlevels in the experimental group 1(17±5)μg/L and control group(23±6)μg/L were higher than those of the experimental group2(13±4)μg/L, experimental group 3(12±4)μg/L, respectively(P<0.05); the serum PGⅡ levels in the control group were higher than that of the experimental group 2(13±4)(P>0.05); the PG I and PGⅡ value in experimental group 1, experimental group 2, experimental group 3 decreased progressively; the serum PG levels in patients with different etiology of liver cirrhosis compared little difference, no statistically significant. Conclusion Serum PG I and PGⅡ can better evaluate the secretion function of gastric mucosa, and can predict the formation of PHG in cirrhosis. According to the level of both, the evaluation and clinical treatment of PHG with different courses of liver cirrhosis are carried out.
Objective To observe the serum pepsinogen(PG) level in patients with liver cirrhosis and to analyze the correlation between the serum PG level and severity of cirrhosis portal hypertensive gastropathy(PHG). Methods The experimental group consisted 110 patients with liver cirrhosis treated in our hospital from June 2015 to March2018, including 77 cases of liver cirrhosis,18 cases of alcoholic liver cirrhosis,9 cases of autoimmune cirrhosis and 6cases of primary biliary cirrhosis. The control group consisted of 20 healthy subjects. All participants participated in the diagnosis of gastric mucosal PHG. Among them, 59 cases of cirrhosis without PHG were treated as experimental group 1, 31 cases of cirrhosis with mild PHG as experimental group 2, 20 cases of cirrhosis with severe PHG as experimental group 3. The serum levels of PG I and PGⅡ in the experimental group, the control group and different kinds of sclerosis cases were detected. The data were analyzed and compared. Results The serum PG I levels in the control group(183±62)μg/L were higher than those in the experimental group 1(160 ±53)μg/L, experimental group 2(82±34)μg/L, experimental group 3(85±35)μg/L, respectively(P<0.05); the serum PG I levels in the experimental group 1 were higher than those of the experimental group 2 and experimental group 3, respectively(P<0.05); the serum PGⅡlevels in the experimental group 1(17±5)μg/L and control group(23±6)μg/L were higher than those of the experimental group2(13±4)μg/L, experimental group 3(12±4)μg/L, respectively(P<0.05); the serum PGⅡ levels in the control group were higher than that of the experimental group 2(13±4)(P>0.05); the PG I and PGⅡ value in experimental group 1, experimental group 2, experimental group 3 decreased progressively; the serum PG levels in patients with different etiology of liver cirrhosis compared little difference, no statistically significant. Conclusion Serum PG I and PGⅡ can better evaluate the secretion function of gastric mucosa, and can predict the formation of PHG in cirrhosis. According to the level of both, the evaluation and clinical treatment of PHG with different courses of liver cirrhosis are carried out.
引文
[1]凌萌智,刘扬河,张艳,等.肝硬化门脉高压性胃病血清胃蛋白酶原的变化及意义[J].现代中西医结合杂志,2015,24(6):654-656.
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[9]刘光伟,赵文霞,桂松林.肝硬化门静脉高压性胃病患者出血风险与幽门螺杆菌感染的相关性研究[J].中国全科医学,2016,107(12):4-5.
[10]陆霞娟.肝硬化门静脉高压性胃病患者中血管紧张素转换酶与C反应蛋白水平变化分析[J].医学综述,2016,22(7):1385-1388.
[11] Bang CS,Kim HS,Suk KT,et al. Portal hypertensive gastropathy as a prognostic index in patients with liver cirrhosis[J].Bmc Gastroenterol,2016,16(1):96.
[12] Subramaniam S,Dadds H,Besherdas K. PTH-008 portal hypertensive gastropathy in the non cirrhotic patient:are we investigating this endoscopic finding adequately?[J]. Gut,2015,64(1):408.
[13] Kiyono S,Maruyama H,Kondo T,et al. Hemodynamic effect of the left gastric artery on esophageal varices in patients with cirrhosis[J]. J Gastroenterol,2016,51(9):900-909.
[14] Macedo GFSD,Aranzana EMDC,Ribeiro MA,et al. Endoscopic contrast enhanced ultrasound in the study of portal hypertensive gastropathy[J]. HPB,2016,18:529-530.
[15] Iijima K,Koike T,Ara N,et al. Identification of a high-risk group for low-dose aspirin-induced gastropathy by measuring serum pepsinogen in H. pylori-infected subjects[J]. J Gastroenterol,2015,50(3):305-312.
[2]张慧,郑勇,陈卫刚,等.肝硬化门静脉高压性胃病患者血清胃蛋白酶原水平变化及意义[J].山东医药,2016,56(10):44-45.
[3]祝小林,佘昌华,王志雄.血清胃蛋白酶原对肝硬化患者胃黏膜功能的评估价值[J].海南医学,2015,6(14):2104-2106.
[4]张莉,谢永强,郑复鹏.肝硬化患者胃黏膜病变与血清胃蛋白酶原水平变化[J].实用肝脏病杂志,2015,7(2):193-194.
[5]王宏利,田艳红,阚洪敏,等.Fibroscan与乙型肝炎肝硬化患者门脉高压性胃病相关性研究[J].陕西医学杂志,2015,11(3):327-329.
[6]曹华,方传华,陈佳婕.血清胃蛋白酶原水平变化对肝硬化患者胃黏膜功能的评估价值[J].标记免疫分析与临床,2016,23(11):1286-1287.
[7]王丹,何锐,何媛,等.门脉高压性胃病患者血清胃蛋白酶原检测的意义[J].实用肝脏病杂志,2016,19(1):94-95.
[8]赵智,罗俊卿,刘小利,等.影响门静脉高压性胃病的多因素回归分析[J].医学临床研究,2015,37(6):1180-1182.
[9]刘光伟,赵文霞,桂松林.肝硬化门静脉高压性胃病患者出血风险与幽门螺杆菌感染的相关性研究[J].中国全科医学,2016,107(12):4-5.
[10]陆霞娟.肝硬化门静脉高压性胃病患者中血管紧张素转换酶与C反应蛋白水平变化分析[J].医学综述,2016,22(7):1385-1388.
[11] Bang CS,Kim HS,Suk KT,et al. Portal hypertensive gastropathy as a prognostic index in patients with liver cirrhosis[J].Bmc Gastroenterol,2016,16(1):96.
[12] Subramaniam S,Dadds H,Besherdas K. PTH-008 portal hypertensive gastropathy in the non cirrhotic patient:are we investigating this endoscopic finding adequately?[J]. Gut,2015,64(1):408.
[13] Kiyono S,Maruyama H,Kondo T,et al. Hemodynamic effect of the left gastric artery on esophageal varices in patients with cirrhosis[J]. J Gastroenterol,2016,51(9):900-909.
[14] Macedo GFSD,Aranzana EMDC,Ribeiro MA,et al. Endoscopic contrast enhanced ultrasound in the study of portal hypertensive gastropathy[J]. HPB,2016,18:529-530.
[15] Iijima K,Koike T,Ara N,et al. Identification of a high-risk group for low-dose aspirin-induced gastropathy by measuring serum pepsinogen in H. pylori-infected subjects[J]. J Gastroenterol,2015,50(3):305-312.