Shimoyama Tadashi, Chinda Daisuke, Matsuzaka Masashi, Takahashi Ippei, Nakaji Shigeyuki, Fukuda Shinsaku
Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
J Gastroenterol Hepatol. 2014 Dec;29 Suppl 4:25-8. doi: 10.1111/jgh.12773.
In Japan, the prevalence of Helicobacter pylori infection is decreasing and the number of patients who receive eradication therapy is increasing. Although the serum level of gastrin is affected by H. pylori infection, the normal level has been unchanged for more than 20 years. The aim of this study was to study whether the present normal range for the serum gastrin level is appropriate for Japanese at present or in the near future.
We studied 810 adults (40-80 years old) who participated in a health survey in 2012. We measured H. pylori stool antigen, titer of serum antibody to H. pylori, and serum level of gastrin. The patient's H. pylori status was defined as positive or negative when the results of both stool antigen and serology were concordant. Subjects who were taking proton-pump inhibitor and had a previous history of gastric surgery were excluded.
Mean serum level of gastrin was 66.2±49.6 pg/mL in 281 H. pylori-negative subjects and 69.7±42.2 pg/mL in 115 patients who had H. pylori eradicated at least 2 years ago. The level of gastrin was 134.4±145.6 pg/mL in 224 patients with H. pylori infection and the level was significantly higher when compared with those in uninfected subjects and eradicated patients (P<0.01).
Because the situation of H. pylori infection has changed remarkably in Japan, a new appropriate normal range of gastrin should be established using current Japanese populations.
在日本,幽门螺杆菌感染率正在下降,接受根除治疗的患者数量正在增加。尽管胃泌素的血清水平受幽门螺杆菌感染的影响,但正常水平在20多年来一直未变。本研究的目的是探讨目前血清胃泌素水平的正常范围是否适用于当前或不久将来的日本人。
我们研究了2012年参加健康调查的810名成年人(40 - 80岁)。我们检测了幽门螺杆菌粪便抗原、幽门螺杆菌血清抗体滴度以及胃泌素的血清水平。当粪便抗原和血清学结果一致时,患者的幽门螺杆菌状态被定义为阳性或阴性。排除正在服用质子泵抑制剂和有胃手术史的受试者。
281名幽门螺杆菌阴性受试者的胃泌素平均血清水平为66.2±49.6 pg/mL,115名至少在2年前已根除幽门螺杆菌的患者的胃泌素平均血清水平为69.7±42.2 pg/mL。224名幽门螺杆菌感染患者的胃泌素水平为134.4±145.6 pg/mL,与未感染受试者和根除患者相比,该水平显著更高(P<0.01)。
由于日本幽门螺杆菌感染情况已发生显著变化,应使用当前日本人群建立新的合适的胃泌素正常范围。