幽门螺杆菌阳性和阴性受试者中胃蛋白酶原I/II比值与年龄或上消化道疾病的关系

[Relationship between pepsinogen I/II ratio and age or upper gastrointestinal diseases in Helicobacter pylori-positive and -negative subjects].

作者信息

Paik Chang Nyol, Chung In-Sik, Nam Kwan Woo, Kwon Jung Hyun, Chang Jae Hyuck, Suh Jung Pil, Park Jae Myung, Cho Yu Kyung, Lee In Seok, Kim Sang Woo, Choi Myung-Gyu

机构信息

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Korean J Gastroenterol. 2007 Aug;50(2):84-91.

PMID:17928751

Abstract

BACKGROUND/AIMS: Although previous reports suggested that pepsinogen (PG) I/II ratio was the index of gastric atrophy, PG I/II ratio was also related to other factors such as Helicobacter pylori (H. pylori) infection, various gastrointestinal diseases, and aging. The aim of this study was to evaluate the relationship between serum PG I/II ratio and age or upper gastro-intestinal diseases according to H. pylori infection status.

METHODS

A total of 529 individuals (307 male; mean age, 57.2 years) were divided into 4 groups (94 gastric ulcers, 35 duodenal ulcers, 105 reflux esophagitis, and 295 atrophic gastritis) according to endoscopic diagnosis. H. pylori infection was determined by H. pylori IgG antibody (ELISA) and PG was measured by latex immunoassay.

RESULTS

H. pylori infected patients showed markedly increased serum PG II levels (24.0+/-14.7 ng/mL vs. 13.8+/-16.6 ng/mL, p0.001) and low PG I/II ratio (3.9+/-2.0 vs. 6.0+/-2.5, p0.001) than non-infected subjects. In H. pylori infected patients, mean PG I/II ratios in the gastric ulcer and atrophic gastritis group were significantly lower than those of the duodenal ulcer and reflux esophagitis group (p0.001, ANOVA, Turkey's multiples comparison test). The mean ratio of open type atrophic gastritis was lower than that of close type atrophic gastritis (3.0+/-1.4 vs. 3.8+/-1.7, p0.005). PG I/II ratio gradually decreased with age in H. pylori-infected patients with atrophic gastritis (R(2)=0.9, p=0.005, linear regression analysis).

CONCLUSION

Serum PG I/II ratio reflects H. pylori infection and gastric atrophy. In the presence of H. pylori infection, gastric atrophy progresses with age.

摘要

背景/目的：尽管先前的报告表明胃蛋白酶原（PG）I/II比值是胃萎缩的指标，但PG I/II比值也与其他因素相关，如幽门螺杆菌（H. pylori）感染、各种胃肠道疾病和衰老。本研究的目的是根据H. pylori感染状况评估血清PG I/II比值与年龄或上消化道疾病之间的关系。

方法

根据内镜诊断，将529例个体（307例男性；平均年龄57.2岁）分为4组（94例胃溃疡、35例十二指肠溃疡、105例反流性食管炎和295例萎缩性胃炎）。通过H. pylori IgG抗体（ELISA）检测H. pylori感染，并通过乳胶免疫测定法测量PG。

结果

与未感染的受试者相比，H. pylori感染患者的血清PG II水平显著升高（24.0±14.7 ng/mL对13.8±16.6 ng/mL，p<0.001），PG I/II比值较低（3.9±2.0对6.0±2.5，p<0.001）。在H. pylori感染患者中，胃溃疡和萎缩性胃炎组的平均PG I/II比值显著低于十二指肠溃疡和反流性食管炎组（p<0.001，方差分析，Turkey多重比较检验）。开放型萎缩性胃炎的平均比值低于闭合型萎缩性胃炎（3.0±1.4对3.8±1.7，p<0.005）。在患有萎缩性胃炎的H. pylori感染患者中，PG I/II比值随年龄逐渐降低（R²=0.9，p=0.005，线性回归分析）。