| Objective:In the high-risk population(age ≥40 years)of high morbidity region of gastric cancer to know the relationship between Hp infection and pepsinoge;to observe the change of serum pepsinogen leverls after the success of Helicobacter pylori aradication with different ages,stomach diseases,times.and to explore whether serum pepsinogen(PGⅠ,PGⅡ,PGⅠ/Ⅱ)could be used as the index for judging the gastric mucosa about Hp infection.Methods:subjects whose come form the digestive medicine in Yan’an University Hospital age ≥ 40 years August 2015 to December 2016 underwent 14 C breath test,gastroscopy,gastric mucosal biopsy and tissue staining Hp detection.according to Hp infection and gastricoscopy,divide subjects into Hp positive group and Hp negative normal group.Hp positive group was divided into A,B,C group with SPSS software.PGI,PG Ⅱand PGⅠ/ Ⅱwere detected at different time after eradication by enzyme-linked immunosorbent assay(ELISA),and the effect of H.pylori sterilization was determined through 14 C urea breath test.make use of SPSS20.0 software to statistically analyze all of the data,and the appropriate time after the eradication of Helicobacter pylori was determined by the small area of the area under the roc curve(ROC).In this research,serve α= 0.05 as the standard,The difference of P <0.05 makes sense statistically.Result:There were 425 subjects who fit in with the inclusion criteria and exclusion criteria,including 105 cases of Hp negative and 320 cases of Hp positive,including 110 cases in group A,116 cases in group B and 94 cases in group C.32 cases of Hp positive were lost during follow-up,including 10 cases in group A,11 cases in group B and 10 cases in group C,eliminate those.1.Yan’an area age ≥ 40 years people the levels of PG in the normal group,AⅠ group,B group and C group were(122.12 ± 75.33)ug / L,(147.64 ± 75.66)ug / L,(142.42 ± 6.25)ug/L,(14.25 ± 8.07)ug/L,(14.81 ± 11.70)ug/L,(17.23 ± 11.69),and the serum PGI level was(8.80 ± 62.7)ug/L,(14.25 ± 8.07)ug/L(9.03 ± 16.03)ug/L,(7.90 ± 10.50)ug/L,(6.30 ± 10.02)ug/L,(6.92 ± 9.21),respectively.Compared with the normal group,the levels of PG Ⅰand PG Ⅱin serum of these three Hp positive groups(A,B,C)were significantly increased,and the ratio of PGⅠ/ Ⅱin serum was significantly decreased.The difference make sense statistically.2.Compared with pretherapy,the levels of PG Ⅰand PG Ⅱin the eradiction success group were decreased(149.77 ± 72.07vs100.42 ± 43.56 ug / L,P =0.000;16.26 ± 11.10vs10.00 ± 6.40ug/L,P =0.000)PGⅠ/ ratio was increased obviously(7.46 ± 9.65 Ⅱvs 9.45 ± 11.17,P =0.000),Between the pretherapy and the post-treatment was statistically significant(P<0.05).3.Compared with pretherapy,In the different age groups(40~49 years old,50~59 years old,60~),the levels of PG Ⅰand PG Ⅱin the sterilization group were significantly decreased(91.22 ± 35.63vs149.55 ± 76.07 、 103.88 ± 40.45vs149.83 ±86.46、106.48±55.89vs150.00±87.60;9.85±7.48vs14.97±11.39、11.42±8.89vs17.35±10.34、9.73±6.34vs15.98±11.93,P=0.000).There were significant differece between groups(P <0.05).the serum PG Ⅰ/Ⅱ of 40~49 and 50~59 years old were increased(11.60±11.12vs7.76±10、8.67±8.89vs7.61±9.24,P=0.017,P=0.013).there were no differece about the serum PG Ⅰ/Ⅱ of 60~years(7.55 + 11.77vs7.51 + 10.84,P= 0.243 > 0.05).In the untreated group,there was no significant difference in serum PGⅠ,PG Ⅱand PG Ⅰ/ Ⅱbetween different age groups.There was no significant linear correlation between serum PG level and age in all age groups before and after treatment(P> 0.05).4.Compared with pretherapy,In non-atrophic gastritis group,atrophic gastritis,Gastric ulcer and mucosal erosion group were significantly decreased(97.51 ±38.63vs155.79 ± 70.71 、 98.93 ± 45.07vs138.25 ± 59.62 、 105.84 ± 40.64vs153.84 ±64.43;9.37±5.37vs14.53±7.95、11.50±6.66vs17.88±8.45、10.01±7.73 vs 16.70±13.55,P=0.000)the levels of PG and PGⅠ Ⅱ;the ratio of PGⅠ/ was higher thⅡ an the control groups(P <0.05).There was significant difference between the three groups(P <0.05).There was no difference in the serum PG level between the disease groups.5.Compared with pretherapy group and the untreated group,the level of PG Ⅰdecreased by 55.42%,80.09% and 80.09%,and the level of PG decreased by 80.94%,Ⅱ52.4%,71.78% %;PGⅠ/ ratio increased by 134.32%,115.15% and 116.48%.After Ⅱeradication of Hp infection in January,the level of PGI in the sterilization success group was significantly decreased,and the serum PGⅠ/ Ⅱratio was significantly increased.After eradication of Hp infection in February,the level of serum PG Ⅱin the success group was significantly lower.After the eradication of infection,the ratio of PGⅠ,PG Ⅱand PGⅠ/ Ⅱin the success group was changed,the amplitude was not obvious,the difference was statistically significant.There was no significant difference between the untreated group and the untreated group.Conclusion1.In the high-risk population(age ≥40 years)of high morbidity region of gastric cancer Helicobacter pylori infection can cause serum PG Ⅰ,PG Ⅱlevels were significantly increased,PGⅠ/ levels were significantly reduced;Ⅱ2.After the eradication of Hp infection success,the level of serum PG I and PG II levels were reduced,PG I / II levels were significantly increased,which could be used as one of indicators about a clinical judgment of HP infection influence gastric secretion function and clinical judgment of Hp infection affect the secretion of gastric mucosa;3.Aafter one month of successful group the level of PGⅠwas significantly decreased,and PGⅠ/Ⅱwas significantly increased,suggesting that the first months after the eradication of Helicobacter pylori is the appropriate time to determine serum PG levels... |
PDF Full Text Request