患儿血清胃蛋白酶原、血清胃泌素、胃黏膜组织学和幽门螺杆菌毒力因子的关系

作     者：Lopes A.I. Palha A. Lopes T. 张诗峰 

作者机构：Gastroenterology Unit Paediatric Department University Hospital Santa Maria Lisbon Portugal Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第11期

页      面：45-46页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：血清胃蛋白酶原 血清胃泌素 胃黏膜组织 毒力因子 组织学方法 胃镜检查 消化性溃疡 尿素酶 菌株数 

摘      要：Objective. Serum pepsinogens and gastrin have been proposed as markers of gastritis, but have seldom been studied in children. In this study the aim was to identify host-and Helicobacter pylori-related factors linked to variations in serum gastrin, PGI, PGⅡ, and to evaluate the potential of these biomarkers for diagnosing gastritis, whether H. pylori-associated or not. Material and methods. Ninety-two dyspeptic children referred for endoscopy (peptic ulcer exclusion) were included in the study. H. pylori status (urease, culture, histology) was assessed, and genotype determined (PCR) in H. pylori-positive subjects. Serum gastrin, PGI and PGⅡ levels were measured by standard radioimmunoassay (RIA). Results. PGI and PGⅡ levels were significantly higher in H. pylori-positive subjects (p = 0.007; p = 0.012, respectively). Gastrin levels were significantly higher in H. pylori-negative subjects (p = 0.035). PGI and PGⅡ were associated significantly with higher antrum inflammation scores (p = 0.002; p = 0.016, respectively); only PGI was associated with age, after controlling for inflammation (p = 0.033) and for activity (p = 0.037). The contribution of virulence factors could not be assessed owing to the low number of virulent strains. After multivariate analysis, only antrum inflammation was independently associated with PGI level (p = 0.012). Receiver operating characteristic (ROC) analysis showed a low PGI and PGⅡ discriminant power for predicting antrum inflammation. Conclusions. Pepsinogen levels as measured in this study seem predominantly to reflect antral inflammation, but they are not an effective screening test for gastritis (H. pylori-positive or -negative) in dyspeptic children.