CAJ | 학술논문

目的：探讨表皮生长因子（EGF）和前列腺素E2（PGE2）在合并幽门螺杆菌（Hp）感染的胃上皮内瘤变（ GIN）患者中的作用。方法选取2012年5月-2013年4月武汉市中心医院收治的胃镜下初次行黏膜钳取活检，病理诊断为低级别GIN（ LGIN）患者82例，快速尿素酶法检测Hp阳性58例、Hp阴性24例，采用酶联免疫吸附试验（ ELISA）法检测静脉血中EGF及PGE2水平。结果82例患者初次胃镜诊断为浅表性胃炎16例、糜烂性胃炎52例、出血性胃炎9例、萎缩性胃炎5例。病理诊断为慢性炎症伴LGIN，其中轻度炎症34例、中度炎症42例、重度炎症6例。Hp阳性患者较Hp阴性血清EGF水平升高〔（180.7依49.9）ng/L与（68.5依1.7）ng/L，P<0.05〕，PGE2水平降低〔（11.8依1.8） ng/L与（21.0依3.4） ng/L，P<0.05〕。Hp阳性和Hp阴性不同胃镜下分型患者血清EGF、PGE2水平比较，差异无统计学意义（ P>0.05）。Hp阳性和Hp阴性不同病理分级患者血清EGF、PGE2水平比较，差异有统计学意义（ P<0.05）。结论合并Hp感染GIN患者血清EGF水平高于未合并Hp感染者，血清EGF和PGE2在合并Hp感染GIN患者胃黏膜损伤中起一定作用。
목적：탐토표피생장인자（EGF）화전렬선소E2（PGE2）재합병유문라간균（Hp）감염적위상피내류변（ GIN）환자중적작용。방법선취2012년5월-2013년4월무한시중심의원수치적위경하초차행점막겸취활검，병리진단위저급별GIN（ LGIN）환자82례，쾌속뇨소매법검측Hp양성58례、Hp음성24례，채용매련면역흡부시험（ ELISA）법검측정맥혈중EGF급PGE2수평。결과82례환자초차위경진단위천표성위염16례、미란성위염52례、출혈성위염9례、위축성위염5례。병리진단위만성염증반LGIN，기중경도염증34례、중도염증42례、중도염증6례。Hp양성환자교Hp음성혈청EGF수평승고〔（180.7의49.9）ng/L여（68.5의1.7）ng/L，P<0.05〕，PGE2수평강저〔（11.8의1.8） ng/L여（21.0의3.4） ng/L，P<0.05〕。Hp양성화Hp음성불동위경하분형환자혈청EGF、PGE2수평비교，차이무통계학의의（ P>0.05）。Hp양성화Hp음성불동병리분급환자혈청EGF、PGE2수평비교，차이유통계학의의（ P<0.05）。결론합병Hp감염GIN환자혈청EGF수평고우미합병Hp감염자，혈청EGF화PGE2재합병Hp감염GIN환자위점막손상중기일정작용。
Objective To investigate the effect of epidermal growth factors(EGF)and prostaglandin E2(PGE2)on histopathological manifestations of gastric mucosa in the patients with gastric intraepithelial neoplasia( GIN)with helicobacter py-lori( Hp)infection. Methods 82 patients with low-grade GIN( LGIN)confirmed by pathological diagnosis in Central Hospi-tal of Wuhan from May 2012 to April 2013 were selected. 58 cases had positive Hp and 24 cases had negative Hp by rapid urease test. The EGF and PGE2 levels in venous blood were examined by enzymelinked immunosorbent assay(ELISA). Results The first application of gastroscope on the 82 patients showed that 16 cases were superficial gastritis,52 cases were erosive gastritis,9 cases were hemorrhagic gastritis and 5 cases were atrophic gastritis. Pathological diagnosis showed chronic inflammation,and 34 cases were mild inflammation,42 cases were moderate inflammation and 6 cases were severe inflammation. Compared with nega-tive Hp patients,the positive Hp patients had higher serum EGF level〔(180. 7±49. 9) ng/L vs. (68. 5±1. 7) ng/L,P<0. 05〕,lower PGE2 level〔(11. 8±1. 8)ng/L vs. (21. 0±3. 4)ng/L,P<0. 05〕. The serum EGF and PGE2 levels be-tween positive Hp patients and negative Hp patients with different endoscopic classifications showed no statistically significant difference(P>0. 05),while the serum EGF and PGE2 between positive Hp patients and negative Hp patients with different pathological classifications showed statistically significant differences(P<0. 05). Conclusion GIN patients combined with Hp infection have higher levels of serum EGF,indicating the EGF and PGE2 may play a role in the damage of gastric mucosa in pa-tients with GIN combined with Hp infection.