胃蛋白酶原和胃泌素17在诊断萎缩性胃炎中的价值

doi:10.3969/j.issn.1004-583X.2019.05.004

临床荟萃

胃蛋白酶原和胃泌素17在诊断萎缩性胃炎中的价值

浙江中医药大学附属第一医院消化内科，浙江杭州 310006

出版日期:2019-05-20 发布日期:2019-06-28
通讯作者: 吕宾, Email: lvbin@medmail.com.cn
作者简介:吕宾，浙江中医药大学附属第一医院消化科主任医师、内科学教授、博士生导师，国务院政府特贴专家、浙江省有突出贡献中青年专家，中华医学会消化病学分会常委、浙江省医学会消化病分会主任委员、浙江省抗癌协会胃癌专业委员会主任委员。
基金资助:
国家自然科学基金资助项目----应激通过CRF上调CK8介导肠上皮通透性改变在肠易激综合征发病中的作用研究（81470814）

Value of serum pepsinogens and gastrin 17 for diagnosis of atrophic gastritis

Department of Gastroenterology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China

Online:2019-05-20 Published:2019-06-28
Contact: Corresponding author: Lv Bin, Email: lvbin@medmail.com.cn

摘要/Abstract

摘要： 胃蛋白酶原（pepsinogens，PG）是胃蛋白酶的前体，包括PG Ⅰ和PG Ⅱ。在胃黏膜萎缩时，血清PG Ⅰ和PG Ⅱ浓度随萎缩程度的加重而逐渐降低，因PG Ⅰ降低较PG Ⅱ更为明显，PG Ⅰ/Ⅱ比值降低。PG Ⅰ和（或）PG Ⅰ/Ⅱ比值降低可作为萎缩性胃炎的血清学诊断方法。胃泌素17由胃窦的G细胞产生，其血清浓度取决于胃内酸度和G细胞数量，当胃窦萎缩时其浓度降低、胃体萎缩则升高。血清PG联合胃泌素17诊断萎缩性胃炎的灵敏度、特异度分别为74.7%、95.6%，阴性预测值为91%，可用于胃癌风险的分层和高危人群的胃癌筛查。但血清PG、胃泌素17浓度受幽门螺杆菌感染、质子泵抑制剂使用、年龄、性别等因素影响。

关键词: 胃炎, , 萎缩性；胃蛋白酶原类；胃泌素类；诊断

Abstract: Pepsinogens (PGs) which consists of two types: pepsinogen I (PGI) andpepsinogen Ⅱ (PGⅡ) are the precursors of pepsin. In patients with gastric mucosal atrophy,the serum concentrations of PGI and PGⅡ decrease with the development of atrophy. PGI has a more obvious decrease than PGⅡ, so the PGI/Ⅱ ratio is lower. Low PGI, low PGI/Ⅱ ratio, or low values of both are good serological indicators of atrophic gastritis. Gastrin 17 (G17) is produced by G cells in the antrum. Serum G17 concentration depends on the intragastric acidity and the number of G cells. G17 can detect atrophic gastritis limited to the antrum (low G17 concentration) or the corpus (high G17 concentration). The combination of PG and G 17 is a useful tool for the diagnosis of atrophic gastritis, applied to the gastric cancer risk stratification and screening of high risk populations, with the higher sensitivity, specificity and negative predictive value(74.7%, 95.6% and 91%, respectively). But, serum PG and G17 concentrations are affected by Hp, PPI use, age, gender and other factors.

Key words: gastritis, , atrophic；pepsinogens；gastrins；diagnosis

应笑，吕宾. 胃蛋白酶原和胃泌素17在诊断萎缩性胃炎中的价值[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2019.05.004.

Ying Xiao, Lv Bin. Value of serum pepsinogens and gastrin 17 for diagnosis of atrophic gastritis[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2019.05.004.

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https://huicui.hebmu.edu.cn/CN/Y2019/V34/I5/403

胃蛋白酶原和胃泌素17在诊断萎缩性胃炎中的价值

Value of serum pepsinogens and gastrin 17 for diagnosis of atrophic gastritis

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