论文部分内容阅读
目的检测辽宁庄河居民血清胃蛋白酶原(PG)含量,以明确其基本人群分布特征,并探讨相关影响因素。方法利用酶联免疫吸附试验(ELISA)方法对辽宁庄河地区6990名居民进行血清PGⅠ、PGⅡ含量检测,并计算PGⅠ/Ⅱ比值；利用胃镜及胃黏膜组织病理学检查进行胃疾病诊断；利用ELISA法检测血清幽门螺杆菌(Hp)IgG抗体滴度。结果辽宁庄河地区居民血清PGⅠ、PGⅡ及PGⅠ/Ⅱ中位值分别为86．9μg/L、10．6μg/L和8．1。男性血清PGⅠ、PGⅡ(95．2μg/L、12．1μg/L)显著高于女性(79．7μg/L、9．4μg/L；P=0．000),PGⅠ/Ⅱ(7．9)显著低于后者(8．3,P=0．000)。PGⅠ/Ⅱ随年龄增高呈阶段性显著降低。PGⅠ/Ⅱ在胃黏膜由基本正常(10．4)向非萎缩性病变(8．8)、萎缩性病变(6．6)转变过程中呈显著性降低。Hp感染者血清PGⅠ、PGⅡ(88．7μg/L,11．4μg/L)显著高于非感染者(81．4μg/L,8．4μg/L；P=0．000),PGⅠ/Ⅱ(7．7)显著低于后者(9．6,P=0．000)。以PGⅠ/Ⅱ为指标筛选胃黏膜萎缩性病变,ROC曲线下面积为0．622,最适临界值为6．9,灵敏度53．2％,特异度67．5％。多因素Logistic回归分析,男性(OR：1．151,95％CI：1．042～1．272,P=0．006)、年龄≥61岁(OR：1．358,95％CI：1．188～1．553,P=0．000)、萎缩性病变(OR：2．075,95％CI：1．870～2．302,P=0．000)及Hp感染(OR：1．546,95％CI：1．368～1．748,P=0．000)是明显影响PGⅠ/Ⅱ水平的因素。结论辽宁庄河居民血清PG水平呈明显偏态分布,受性别、年龄因素影响,与胃疾病和Hp感染密切相关。PGⅠ/Ⅱ较之PGⅠ和PGⅡ,更适用于胃疾病筛查。
Objective To detect the serum pepsinogen (PG) content of residents in Zhuanghe, Liaoning Province, so as to clarify the distribution characteristics of its basic population and to explore the related factors. Methods The levels of PGⅠ and PGⅡ in 6,990 residents in Zhuanghe district of Liaoning Province were detected by enzyme-linked immunosorbent assay (ELISA), and the ratio of PGⅠ / Ⅱ was calculated. The gastric diseases were diagnosed by gastroscopy and gastric mucosa histopathology. Method to detect serum Helicobacter pylori (Hp) IgG antibody titer. Results The median of serum PGⅠ, PGⅡ and PGⅠ / Ⅱ in Zhuanghe district of Liaoning Province were 86.9μg / L, 10.6μg / L and 8.1. PGI / PGⅡ (95.2μg / L, 12.1μg / L) in male was significantly higher than that in female (79.7μg / L, 9.4μg / L; Significantly lower than the latter (8.3, P = 0.000). PGⅠ / Ⅱ was significantly decreased with age. PGⅠ / Ⅱin the gastric mucosa from the basic normal (10.4) to non-atrophic lesions (8.8), atrophic lesions (6.6) during the transition was significantly decreased. The serum levels of PGⅠ and PGⅡ in Hp-infected patients were significantly higher than those in non-infected patients (81.4μg / L, 8.4μg / L; P = 0.000) 7.7) was significantly lower than the latter (9.6, P = 0.000). Gastric mucosal atrophic lesions were screened with PGⅠ / Ⅱ as index, the area under ROC curve was 0.622, the optimal cutoff value was 6.9, the sensitivity was 53.2% and the specificity was 67.5%. Multivariate logistic regression analysis showed that the odds ratio (OR: 1.151, 95% CI: 1.042-1.272, P = 0.006) and age≥61 years (OR: 1.358, 95% CI: (OR: 2.075, 95% CI: 1.870-2.2O2, P = 0.000) and Hp infection (OR: 1.546 , 95% CI: 1.368-1.748, P = 0.000) were the factors that significantly influenced the level of PGⅠ / Ⅱ. Conclusion The serum PG level of Zhuanghe residents in Liaoning Province is obviously skewed distribution, which is affected by gender and age, and is closely related to gastric diseases and Hp infection. PG Ⅰ / Ⅱ compared with PG Ⅰ and PG Ⅱ, more suitable for screening of gastric diseases.