本文選題：血清胃蛋白酶原 + 幽門螺旋桿菌��； 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的：檢測(cè)不同胃部疾病患者血清胃蛋白酶原水平及同期健康體檢人群血清胃蛋白酶原(pepsinogen,PG)水平,探討血清胃蛋白酶原I(PGI)、血清胃蛋白酶原Ⅱ(PGⅡ)及其比值(PGⅠ/PGⅡ,PGR)在各類胃部疾病臨床診治中的意義。 方法：以2012年7月至2014年3月在中南大學(xué)湘雅三醫(yī)院接受胃鏡檢查(必要時(shí)活檢)、血清胃蛋白酶原檢測(cè)的健康體檢人群及同期住院患者為研究對(duì)象。根據(jù)內(nèi)鏡加病檢結(jié)果,分組如下：(A)正常對(duì)照組(B)非萎縮性胃炎組(C)慢性萎縮性胃炎組(D)胃潰瘍組(E)十二指腸潰瘍組(F)胃癌組。采用酶聯(lián)免疫吸附法(ELISA)檢測(cè)血清胃蛋白酶原水平。使用統(tǒng)計(jì)軟件SPSS19.0進(jìn)行數(shù)據(jù)統(tǒng)計(jì)處理,構(gòu)建受試者工作特征(ROC)曲線,計(jì)算曲線下面積及臨界值,結(jié)果均以p0.05為差異有統(tǒng)計(jì)學(xué)意義,p0.01為顯著統(tǒng)計(jì)學(xué)差異。 結(jié)果：依據(jù)納入、排除標(biāo)準(zhǔn),共納入研究對(duì)象3086例。1)湖南地區(qū)漢族健康人群中,男女性之間,血清胃蛋白酶原有統(tǒng)計(jì)學(xué)差異(p0.05)；不同年齡組的血清胃蛋白酶原有統(tǒng)計(jì)學(xué)差異(p0.05)。2)健康人群中血清PG95%可信區(qū)間分別為：16～44歲女性：PGⅠ(132.44～139.26ug/L),PGⅡ(6.03～6.87ug/L),PGR(35.19～43.97)；45歲女性：PGⅠ(135.53～144.36ug/L),PGⅡ(6.72～7.54ug/L),PGR(25.54～33.34)；16～44歲男性：PGⅠ(141.18～147.86ug/L),PGⅡ(6.03～6.87ug/L),PGR(29.58～34.68)；45歲男性：PGⅠ(144.74～152.37ug/L), PGⅡ(8.83～9.86ug/L),PGR(23.16～25.88)。3)健康人群中,幽門螺旋桿菌(Hp)陽性組血清PGⅠ、PGⅡ較Hp陰性組顯著增高,而PGR顯著下降(p0.01)。4)PGI：與正常組、慢性萎縮性胃炎組相比,胃潰瘍組PGI增高,差異有統(tǒng)計(jì)學(xué)意義(p0.05).5)PGⅡ:與正常組比較,慢性萎縮性胃炎組、胃癌組均呈顯著增高,差異有統(tǒng)計(jì)學(xué)意義(p0.01)；慢性萎縮性胃炎組、胃癌組血清PGⅡ水平均高于其他各疾病組,統(tǒng)計(jì)學(xué)差異顯著(p0.01)；慢性萎縮性胃炎組、胃癌組之間差異無統(tǒng)計(jì)學(xué)意義。PGⅡ從對(duì)照組→慢性非萎縮性胃炎組→慢性萎縮性胃炎組→胃癌組中呈逐漸上升趨勢(shì)。6)PGR：與正常對(duì)照組相比,慢性萎縮性胃炎組、胃癌組均明顯下降(p0.01),十二指腸潰瘍組較對(duì)照組PGR下降(p0.05)。慢性萎縮性胃炎組、胃癌組與其他各疾病分組差異均有統(tǒng)計(jì)學(xué)意義(p0.01)。十二指腸潰瘍組較胃潰瘍組PGR值明顯降低(p0.01)。PGR在正常組→慢性非萎縮性胃炎組→慢性萎縮性胃炎組→胃癌組中呈下降趨勢(shì)。7)以正常對(duì)照組及胃癌組的血清胃蛋白酶原所做的受試者工作特征曲線(ROC)下的面積分別為PGⅠ0.618、PGⅡ0.860、PGR0.864。8) Hp陽性率：慢性萎縮性胃炎、胃潰瘍、十二指腸潰瘍組Hp感染率分別較其他組高,差異均有統(tǒng)計(jì)學(xué)差異(p0.05)。 結(jié)論：1.湖南地區(qū)漢族健康人群中,年齡、性別、Hp均對(duì)胃蛋白酶原有影響；初步建立了本實(shí)驗(yàn)室血清胃蛋白酶原的醫(yī)學(xué)參考范圍。2.血清胃蛋白酶原可作為胃部疾病的生化檢測(cè)標(biāo)志物,從正常對(duì)照、慢性非萎縮性胃炎、慢性萎縮性胃炎到胃癌組,PGII呈上升趨勢(shì)而PGR呈下降趨勢(shì)；胃潰瘍、十二指腸潰瘍、慢性萎縮性胃炎組Hp感染率較高。3.低PGR值、高PGII水平與胃癌的發(fā)生密切相關(guān),PGⅡ、PGR可作為篩查胃粘膜由萎縮到癌變這一病理學(xué)變化的血清學(xué)指標(biāo)。
[Abstract]:Objective: to detect the serum pepsinogen level in patients with different gastric diseases and the level of serum pepsinogen (Pepsinogen, PG) in healthy people at the same time, and to explore the significance of serum pepsinogen I (PGI), serum pepsinogen II (PG II) and its ratio (PG I /PG II, PGR) in the clinical diagnosis and treatment of various gastric diseases.
Methods: from July 2012 to March 2014, gastroscopy was performed at Xiangya Third Hospital of Central South University (necessary biopsy), the health examination population of serum pepsinogen and patients in the same period were studied. According to the results of endoscopy and disease examination, the following groups were as follows: (A) the chronic atrophic gastritis in the normal group (B) non atrophic gastritis group (C) Group (D) gastric ulcer group (E) group of duodenal ulcer (F) gastric cancer group. Enzyme linked immunosorbent assay (ELISA) was used to detect the level of serum pepsinogen. Statistical software SPSS19.0 was used for data processing, and the working characteristics (ROC) curve of the subjects were constructed, and the product and critical value were calculated under the curve, and the results were statistically significant with P0.05 as the difference. P0.01 Significant statistical differences.
Results: according to the inclusion and exclusion criteria, 3086 cases of.1 in the Hunan Han population were included in the health population of the Han nationality in Hunan. The original statistical difference between male and female, serum pepsin (P0.05), the original statistical difference of serum pepsin (P0.05).2 in different age groups was.2) the PG95% confidence interval of the serum in the healthy Kang population was 16~44 year old women, respectively. : PG I (132.44 ~ 139.26ug/L), PG II (6.03 to 6.87ug/L), PGR (35.19 ~ 43.97); 45 year old women: PG I (135.53 to 144.36ug/L), PG II (6.72 to 7.54ug/L), PGR (25.54 to 33.34); 16~44 years old male: PG (141.18 to 147.86ug/L), 6.03 to 29.58 ~ 34.68 83 to 9.86ug/L), PGR (23.16 to 25.88).3) in the healthy population, the serum PG I in the positive group of Helicobacter pylori (Hp), PG II was significantly higher than that of the Hp negative group, while PGR decreased significantly (P0.01).4) PGI: compared with the normal group and chronic atrophic gastritis group, the PGI increased in the gastric ulcer group, and the difference was statistically significant. In the group of gastritis and gastric cancer, the difference was statistically significant (P0.01). The level of serum PG II in the chronic atrophic gastritis group and the gastric cancer group was higher than that of the other disease groups, the statistical difference was significant (P0.01); the difference between the chronic atrophic gastritis group and the gastric cancer group was no significant difference between the control group and the chronic non atrophic gastritis group. The chronic atrophic gastritis group and gastric cancer group showed a gradual increase of.6) PGR: compared with the normal control group, the chronic atrophic gastritis group and the gastric cancer group were significantly decreased (P0.01), the duodenal ulcer group was lower than the control group PGR (P0.05). The group of chronic atrophic gastritis, gastric cancer group and other disease groups had statistical significance (P0.01). The PGR value of the duodenal ulcer group was significantly lower than that of the gastric ulcer group (P0.01).PGR in the normal group, chronic non atrophic gastritis group, chronic atrophic gastritis group and gastric cancer group, which showed a decreasing trend of.7). The area of the serum pepsinogen of normal control group and gastric cancer group was PG I 0.618, PG II, respectively, and the area of the serum pepsinogen of the normal control group and the gastric cancer group was PG I 0.618. 0.860, PGR0.864.8) Hp positive rate: the rate of Hp infection in chronic atrophic gastritis, gastric ulcer and duodenal ulcer group was higher than that of other groups, the difference was statistically significant (P0.05).
Conclusion: 1. the influence of age, sex and Hp on the original gastric pepsin among healthy people of Han nationality in Hunan area, the medical reference range of serum pepsinogen in our laboratory,.2., can be used as a biochemical marker for gastric disease, from normal to chronic non atrophic gastritis and chronic atrophic gastritis. In the gastric cancer group, PGII showed an upward trend and the PGR showed a downward trend. The rate of Hp infection in gastric ulcer, duodenal ulcer and chronic atrophic gastritis was higher.3. low PGR. The high PGII level was closely related to the occurrence of gastric cancer. PG II, PGR could be used as a serological index to screen the pathological changes of gastric mucosa from atrophy to canceration.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R573

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本文編號(hào)：2096311