Mối liên quan giữa nồng độ pepsinogen, gastrin huyết thanh với viêm dạ dày mãn tính

Background: Helicobacter pylori infection and associated gastritis are weel-known significant factors in many gastrointestinal diseases and the evaluation of these conditions is important to health evaluation. The authors investigate the utiility of serum pepsinogen (PG), gastrin concentrations for the diagnosis of H. pylori infection and the evaluation of the severity of histologic gastritis. Objectives and Methods: The subjects consisted of 270 patients (128 men, 142 women, with mean age of 43 years). Biopsy specimens were obtained from gastric body and an trum to assess the grade of mononuclear and polymorphonuclear cell infiltration, atrophy and intestinal metaplasia, histologic evidence of Helicobacter pylori infection. HP was judged by 5 different methods: culture, histology, immunohistochemistry, rapid urine test and serum IgG antibodies against HP. Pepsinogen and gastrin concentrations were determined by radioimmunoassay. Results: In subjects with H. pylori infection, serum PGII concentrations were increased, and the PGI/PGII ratio was decreased. In patients with active gastritis (especially in moderate and servere grades of gastritis) and atrophy, serum PGII was increased and the PGI/PGII ratio was decreased significantly (p 0.05). When PGI/PGII ratio of 6.5 or less was used as the cutoff points for the diagnosis of atrophy, the sensitivity and specificity of diagnosis were 80.8 percent and 41.7 percent, respectively. When PG~/PGII ratio of 5.5 or less was used as the cutoff points for the diagnosis of HP infection, the sensitivity and specificity of diagnosis were 80.1 percent and 76.6 percent respectively. Gastrin concentration only increased in patients with marked atrophy, there was no significant difference in gastrin concentration between patients with or without intestinal metaplasia (149.2 + or - 81.1 vs 146.4 + or - 103.8; p 0.05). Conclusions: These results suggest that H. pylori infection, gastritis, and glandular atrophy of the stomach can be evaluated via serum PG, gastrin concentrations, allowing the evaluation of gastric mucosal integrity.