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目的 探讨慢性胃病患者血清胃蛋白酶原(PG)增高的病理意义。方法 采用时间分辨荧光免疫分析法(TRFIA)血清PG检测与内镜活检、病理形态学观察相结合对比分析525 例慢性胃病患者血清胃蛋白酶原I(PGI)增高和胃黏膜病变的关系。结果 各种胃黏膜病变中血清PGI值有不同程度增高,但以胃癌组PGI增高的检出率最低,而胃溃疡病组检出率最高,胃溃疡病组患者血清PGI>240μg/L的检出率44.12%,明显高于其他病变组;慢性浅表性胃炎中,伴有异型增生病例及伴有肠上皮化生和异型增生组血清PGI>240μg/L病例的检出率为19.05%和20.51%,明显高于单纯炎症组6.43%(P<0.05)。在慢性萎缩性胃炎组内,尽管也有部分病例血清PGI增高,但病变程度不同的各组间未见明显差异。结论 胃溃疡病患者PGI>240μg/L的检出率明显高于其他病变组。慢性浅表性胃炎患者血清PGI>240μg/L者发生异型增生的几率明显增高,应引起临床医师的关注。
Objective To investigate the pathological significance of elevated serum pepsinogen (PG) in patients with chronic gastritis. Methods The serum level of PGI and gastric mucosal lesion in 525 cases of chronic gastritis patients were analyzed by the combination of time-resolved fluorescence immunoassay (TRFIA) serum PG assay and endoscopic biopsy and pathomorphology. Results The serum PGI levels in various gastric mucosal lesions increased to some extent. However, the highest detection rate of PGI in gastric cancer group was the lowest, while the highest detection rate was in gastric ulcer disease group. Serum PGI> 240μg / L in gastric ulcer patients The rate was 44.12%, which was significantly higher than other groups. The detection rate of PGI> 240μg / L in patients with dysplasia, intestinal metaplasia and dysplasia was 19.05% in chronic superficial gastritis and 20.51%, significantly higher than the simple inflammation group 6.43% (P <0.05). In the group of chronic atrophic gastritis, although there were some cases of serum PGI increased, but no significant differences in the severity of the various groups. Conclusion The detection rate of PGI> 240μg / L in gastric ulcer patients is significantly higher than that in other pathological groups. Chronic superficial gastritis in patients with serum PGI> 240μg / L were significantly increased risk of dysplasia, should arouse the attention of clinicians.