Ikeda Keisei, Chiba Toshimi, Sugai Tamotsu, Kangawa Kenji, Hosoda Hiroshi, Suzuki Kazuyuki
Department of Internal Medicine, Iwate Medical University, Iwate, Japan.
Hepatogastroenterology. 2011 Sep-Oct;58(110-111):1622-7. doi: 10.5754/hge10271. Epub 2011 Jul 15.
BACKGROUND/AIMS: The aim of this study was to clarify the relationship between plasma or mucosal ghrelin levels and endoscopic or histological severity, acid secretion and H. pylori infection associated with chronic gastritis.
We measured plasma and mucosal ghrelin levels in 80 consecutive individuals with chronic gastritis, including 51 H. pylori-positive and 29 H. pylori-negative subjects. The topographic distribution of gastritis was divided into open type and closed type. During endoscopy, five adjacent biopsy specimens were obtained from the antrum, corpus and angulus. Using the updated Sydney System, histological parameters including activity, chronic inflammation, glandular atrophy and intestinal metaplasia were graded. Mucosal ghrelin, fasting plasma ghrelin, serum pepsinogen I and II, gastrin and H. pylori infection were all measured.
All four measured histological parameters were significantly higher in H. pylori-positive patients than in H. pylori-negative patients. Serum pepsinogen I and II levels were also significantly higher in the H. pylori-positive group. Plasma and mucosal ghrelin levels correlated well with the topographic distribution of gastritis, and also with histological parameters of glandular atrophy in the corpus and angulus of the stomach.
Plasma and mucosal ghrelin levels may reflect the extent of atrophy in the stomach irrespective of the presence of H. pylori infection, which is closely associated with the development of chronic gastritis.
背景/目的：本研究旨在阐明血浆或黏膜胃饥饿素水平与内镜或组织学严重程度、胃酸分泌以及与慢性胃炎相关的幽门螺杆菌感染之间的关系。
我们对80例连续性慢性胃炎患者进行了血浆和黏膜胃饥饿素水平检测，其中包括51例幽门螺杆菌阳性和29例幽门螺杆菌阴性患者。胃炎的部位分布分为开放型和封闭型。在内镜检查过程中，从胃窦、胃体和胃角获取五个相邻的活检标本。采用更新后的悉尼系统，对包括活动度、慢性炎症、腺体萎缩和肠化生在内的组织学参数进行分级。检测黏膜胃饥饿素、空腹血浆胃饥饿素、血清胃蛋白酶原I和II、胃泌素以及幽门螺杆菌感染情况。
幽门螺杆菌阳性患者的所有四项检测组织学参数均显著高于幽门螺杆菌阴性患者。幽门螺杆菌阳性组的血清胃蛋白酶原I和II水平也显著更高。血浆和黏膜胃饥饿素水平与胃炎的部位分布以及胃体和胃角的腺体萎缩组织学参数密切相关。
无论是否存在幽门螺杆菌感染，血浆和黏膜胃饥饿素水平可能反映胃萎缩的程度，而幽门螺杆菌感染与慢性胃炎的发生密切相关。
