摘要
目的探讨肝炎后肝硬化患者血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃动素、胃泌素-17特点及与幽门螺杆菌(Hp)感染相关性。方法选择确诊的肝炎后肝硬化患者156例(乙型肝炎137例,丙型肝炎19例)为研究对象,详细记录纳入病例病因、相关临床生化资料,并进行Child-Pugh分级及MELD评分,14C-尿素呼气试验(14C-UBT)确定Hp感染,ELISA法检测血清PGⅠ、PGⅡ、胃动素和胃泌素-17含量。结果纳入病例Child-Pugh不同分级患者血清AST、总胆红素、白蛋白、肌酐、凝血酶原时间、国际标准化比值、MELD评分差异均有统计学意义(P均<0.05);Child-Pugh C级患者血清PGⅡ、胃动素、胃泌素-17水平均高于Child-Pugh A级、B级2组(P均<0.05);门脉主干内径>13 mm者,PGⅠ、PGⅡ、胃动素、胃泌素-17水平均高于≤13 mm者;纳入病例Hp阳性率为58.33%(91/156);Hp阳性组与Hp阴性组相比,年龄、性别及Child-Pugh不同分级情况差异均无统计学意义(P均>0.05);与Hp阴性组相比,Hp阳性组并发门脉高压性胃病、食管胃底静脉曲张及消化性溃疡的比例升高,差异均有统计学意义(P均<0.05);肝硬化Hp阳性组血清PGⅠ、PGⅡ、胃动素、胃泌素-17水平较肝硬化Hp阴性组高(P均<0.05)。结论肝炎后肝硬化患者外周血PGⅠ、PGⅡ、胃动素、胃泌素-17含量升高,Hp感染可能是其升高的机制之一。
Objective To investigate the characteristics of serum levels of pepsinogen Ⅰ (PG Ⅰ), PG Ⅱ, Motilin(MOT), gastric secrete element-17(G-17) and analyze the correlation with Helicobacter pylori(Hp) infection in patients with posthepatitic cirrhosis. Methods A total of 156 patients diagnosed with posthepatitic cirrhosis(137 cases of HBV, 19 cases of HCV) were recruited in this clinical trial. The etiology, relevant clinical biochemical data were recorded in details. Child-Pugh grading and MELD score were performed. 14 C-UBT was performed to determine Hp infection. Serum levels of PG I, PG Ⅱ, MOT and G-17 were detected by ELISA. Results The serum levels of AST, TBIL, ALB, Cr, PT, INR and MELD scores significantly differed among patients with different Child-Pugh grades(all P<0.05). Patients with Child-Pugh grade C had significantly higher levels of PG Ⅱ, MOT and G-17 than those with grade A and B(all P<0.05). The serum levels of PG Ⅰ, PG Ⅱ, MOT and G-17 in patients whose portal vein diameter was > 13 mm were significantly higher than those in patients with portal vein diameter of ≤ 13 mm(all P<0.05). The infection rate of Hp was 58.33%(91/156). Age, gender and Child-Pugh grade did not significantly differ between patients with and without Hp infection(all P>0.05). Compared with patients without Hp infection, the percentage of portal hypertensive gastropathy, esophagogastric varices and peptic ulcer was significantly higher in those with Hp infection(all P<0.05).The serum levels of PG Ⅰ, PG Ⅱ, MOT and G-17 were significantly up-regulated in cirrhosis patients complicated with Hp infection(all P<0.05). Conclusion The serum levels of PG Ⅰ, PG Ⅱ, MOT and G-17 are up-regulated in patients with posthepatitic cirrhosis. Hp infection may be one of the underlying mechanisms.
作者
黄妙灵
刘序友
Huang Miaoling;Liu Xuyou(Health Management Center,Shenzhen Hospital,Southern Medical University,Shenzhen 518110,China)
出处
《新医学》
2020年第1期37-41,共5页
Journal of New Medicine
基金
2019年度广东省中医药局面上科研项目（20191082）
关键词
胃肠激素
幽门螺杆菌
肝炎后肝硬化
Gut hormone
Helicobacter pylori
Posthepatitic cirrhosis
