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目的:探讨血清胃蛋白酶原含量作为幽门螺杆菌根除疗效判定指标的应用价值. 方法:对359例幽门螺杆菌相关性胃疾病患者采取常规三联疗法进行除菌治疗,利用免疫量度放射分析法(IRMA)分别在治疗前和治疗后1、5、18 mo时测定其血清胃蛋白酶原含量,同时利用胃黏膜HE染色、H pylori抗体ELISA检测及H pylori-DNA PCR检测三种方法联合判定H pylori除菌治疗效果. 结果:与治疗前相比,除菌组血清PGI、PGII值显著降低(64.52±31.74 vs 48.02±25.69μg/L,P<0.01;11.22±6.12 vs 7.58±5.41μg/L,P<0.01),PGI/II比值显著升高(6.54±3.57 vs 7.96±4.39,P<0.01).各胃疾病组成功除菌后血清PGI、PGII值均低于治疗前水平.治疗后1、5 mo时,除菌组血清PGI、PGII均显著低于治疗前水平(PGI:66.83±28.04 vs 52.54±27.96 μg/L,P<0.01; 11.85±4.91 vs 6.55±3.59μg/L,P<0.01;PGII:60.19±29.30 vs 43.94±26.27 μg/L;10.93±6.12 vs 6.66±5.30 μg/L,P<0.01;),PGI/II比值则显著升高(5.84±2.38 vs 8.95±4.61,P<0.01;6.60±4.21 vs 8.35±4.82,P<0.01);18 mo时仅PGI值显著降低(68.12±36.05 vs 50.11±23.50μg/L,P<0.01).未除菌组血清PG水平治疗前后无明显变化. 结论:血清胃蛋白酶原含量检测适用于幽门螺杆菌除菌疗效的判定,PGI/II比值可作为早期除菌疗效的判定指标.
Objective: To investigate the value of serum pepsinogen as an indicator to determine the eradication efficacy of Helicobacter pylori.Methods: 359 cases of Helicobacter pylori-associated gastric diseases were treated with conventional triple therapy for the treatment of bacteriolysis. Immuno-metric radiometric assay (IRMA ) Were measured before treatment and 1,5,18 after treatment serum pepsinogen content, while using gastric mucosal HE staining, H pylori antibody ELISA detection and H pylori-DNA PCR detection of three methods to determine H pylori addition Results The serum PGI and PGII of the bacteria-removing group were significantly lower than those before the treatment (64.52 ± 31.74 vs 48.02 ± 25.69μg / L, P <0.01; 11.22 ± 6.12 vs 7.58 ± 5.41μg / L, P <0.01), the PGI / II ratio increased significantly (6.54 ± 3.57 vs 7.96 ± 4.39, P <0.01), the serum PGI and PGII values of all groups were significantly lower than those before treatment (PGI: 66.83 ± 28.04 vs 52.54 ± 27.96 μg / L, P <0.01; 11.85 ± 4.91 vs 6.55 ± 3.59 μg / L, P <0.01; PGII: 60.19 ± 29.30 vs 43.94 ± 26.27 μg / L; 10.93 ± 6.12 vs 6.66 ± 5.30 μg / L, P <0.01; P <0.01). The PGI level was significantly lower at 18 months (68.12 ± 36.05 vs 50.11 ± 23.50 μg / L, P <0.01, P <0.01) ) .The levels of serum PG before and after sterilization did not change significantly.Conclusion: The detection of serum pepsinogen is suitable for the determination of the efficacy of removing Helicobacter pylori, and the PGI / II ratio can be used as the index to determine the efficacy of early sterilization.