首页|幽门螺杆菌感染患者胃蛋白酶原及内皮功能变化对萎缩性胃炎和胃癌的早期评估价值研究

幽门螺杆菌感染患者胃蛋白酶原及内皮功能变化对萎缩性胃炎和胃癌的早期评估价值研究

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目的 探讨幽门螺杆菌(Hp)感染患者胃蛋白酶原及内皮功能变化对萎缩性胃炎和胃癌的早期评估价值.方法 回顾性分析2022年7月至2023年12月收治的慢性胃炎合并Hp感染患者163例的临床资料,其中糜烂性胃炎合并Hp感染患者78例为Hp组,慢性萎缩性胃炎合并Hp感染患者患者57例为萎缩组,胃癌合并Hp感染患者28例为胃癌组.比较三组患者的血清中胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ/PGⅡ比值等者胃蛋白酶原指标水平,血浆—氧化氮(NO)、内皮素-1(ET-1)、细胞间粘附分子-1(ICAM-1)等内皮功能指标水平,采用Spearman相关法分析慢性胃炎合并Hp感染患者胃蛋白酶原及内皮功能指标水平与其病变严重程度的关系.并绘制ROC曲线分析慢性胃炎合并Hp感染患者胃蛋白酶原及内皮功能指标水平对其进展为慢性萎缩性胃炎或胃癌的早期评估价值.结果 与Hp组比较,萎缩组和胃癌组的血清PGⅠ、PGⅠ/PGⅡ比值和血浆NO水平降低而血浆ET-1和ICAM-1水平升高(P<0.05);与萎缩组比较,胃癌组的血清PG Ⅰ、PG Ⅰ/PG Ⅱ比值和血浆NO水平降低而血浆ET-1和ICAM-1水平升高(P<0.05).而三组血清PG Ⅱ水平比较差异无统计学意义(P>0.05).Spearman相关分析结果显示,慢性胃炎合并Hp感染患者血清PG Ⅰ、PG Ⅰ/PG Ⅱ比值和血浆NO水平与其病变严重程度呈负相关(P<0.05);而其血浆ET-1和ICAM-1水平与其病变严重程度则呈正相关(P<0.05).ROC曲线分析结果显示,血清PGⅠ、PGⅠ/PGⅡ比值和血浆NO、ET-1和ICAM-1水平均具有一定的慢性胃炎合并Hp感染进展为慢性萎缩性胃炎或胃癌的早期评估效能,其中各指标联合检测的早期评估效能最佳.结论 Hp感染可导致患者胃蛋白酶原水平降低及内皮功能损伤,且两者相关指标水平联合检测可能作为Hp感染进展为慢性萎缩性胃炎或胃癌风险早期评估参考指标.
The Value of of Pepsinogen and Endothelial Function Changes in Patients with Helicobacter pylori Infection for the Early Evaluation of Atrophic Gastritis and Early Gastric Cancer
Objective To explore the value of pepsinogen and endothelial function changes in patients with Helicobacter pylori(Hp)infection for the early evaluation of atrophic gastritis and gastric cancer.Methods A retrospective analysis was conducted on the clinical data of 163 patients with chronic gastritis complicated with Hp infection admitted from July 2022 to December 2023.Among them,78 patients with erosive gastritis complicated with Hp infection were in the Hp group,57 patients with chronic atrophic gastritis complicated with Hp infection were in the atrophic group,and 28 patients with gastric cancer complicated with Hp infection were in the gastric cancer group.The serum pepsinogen Ⅰ(PG Ⅰ),pepsinogen Ⅱ(PG Ⅱ)levels,and PG Ⅰ/PG Ⅱ ratio,as well as the levels of plasma nitrogen oxide(NO),endothelin-1(ET-1),intercellular adhesion molecule-1(ICAM-1)and other endothelial function indicators among the three groups of patients were compared,and Spearman correlation method was applied to analyze the relationship between the levels of pepsinogen and endothelial function indicators in patients with chronic gastritis complicated with Hp infection with the severity of their lesions.ROC curve was drawn to analyze the early evaluation value of pepsinogen and endothelial function indicators in patients with chronic gastritis and Hp infection for their progression to chronic atrophic gastritis or gastric cancer.Results Compared with those of the Hp group,the serum PG Ⅰ,PG Ⅰ/PG Ⅱ ratio,and plasma NO levels in the atrophic group and gastric cancer group decreased,while the plasma ET-1 and ICAM-1 levels in the atrophic group and gastric cancer group increased(P<0.05);Compared with those of the atrophic group,the serum PG Ⅰ,PG Ⅰ/PG Ⅱ ratio,and plasma NO levels in the gastric cancer group decreased,while plasma ET-1 and ICAM-1 levels in the gastric cancer group increased(P<0.05).There was no statistically significant difference in the levels of serum PG Ⅱ among the three groups(P>0.05).The Spearman correlation analysis results showed that the serum PGⅠ,PG Ⅰ/PG Ⅱ ratio,and plasma NO level in patients with chronic gastritis complicated with Hp infection were negatively correlated with the severity of the disease(P<0.05);The levels of plasma ET-1 and ICAM-1 were positively correlated with the severity of the lesion(P<0.05).The ROC curve analysis results showed that serum PG Ⅰ,PG Ⅰ/PG Ⅱ ratio,and plasma NO,ET-1,and ICAM-1 levels all have certain early evaluation efficacy for the progression of chronic gastritis complicated with Hp infection to chronic atrophic gastritis or gastric cancer.Among them,the combined detection of various indicators had the best early evaluation efficacy.Conclusion Hp infection can lead to a decrease in pepsinogen levels and endothelial dysfunction in patients,and the combined detection of the levels of the two related indicators may serve as reference indicators for early risk assessment of Hp infection progression to chronic atrophic gastritis or gastric cancer.

Helicobacter pyloriPepsinogenEndothelial functionAtrophic gastritisGastric cancerEarly evaluation value

葛君、马玲、李兴华

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200235 上海市第八人民医院消化内科

750003 银川市第一人民医院消化内科

幽门螺杆菌 胃蛋白酶原 内皮功能 萎缩性胃炎 胃癌 早期评估价值

2024

现代消化及介入诊疗
广东省医学学术交流中心

现代消化及介入诊疗

CSTPCD
影响因子:1.019
ISSN:1672-2159
年,卷(期):2024.29(7)