The Relationship Between Cirrhotic Portal Hypertension Gastropathy And Serum Pepsinogen

Objective: To observe the level of serum pepsinogen( PG) I and II in the different degree of liver cirrhosis patients with PHG explore its clinical significance. Methods :125 cases of liver cirrhosis patients with PHG,including 82 males and 43 females(age 57.74±11.99 years old;Hepatitis cirrhosis 107,Alcoholic liver cirrhosis 5,Autoimmune liver cirrhosis 5,Primary cholestasis cirrhosis 8), were diagnosed by clinical,laboratory examination and imaging examination or liver biopsy in The First Hospital Affiliated to Shihezi University Medicine School from December 2013 to August 2015.We observed the gastric mucous of patients by common electronic gastroscope and divided into 3 groups according to McCormick standard(Group A cirrhosis without PHG 50, Group B cirrhosis with mild PHG 37,Group C cirrhosis with sever PHG 38).In the same times,we collected 44 cases of healthy people inculding38 males and 39 females(Control GROUP Group D,age 58.4±12.49) which only had mild non-atrophic gastritis or did not have any gastritis according to the results of common electronic gastroscope and pathology.None of them had Primary liver cancer, gastric cancer, atypical hyperplasia,severe cardiopulmonary dysfunction, chronic kidney disease, and nearly a month not taking antibiotics, proton pump inhibitor, gastric mucous protectant,non-steroidal anti-inflammatory drugs(Nsaids), etc. We collected fasting venous blood of these 4 group people to serum PGI and II and PGⅠ/PGⅡ levels were measured by Latex enhanced immune turbidometry.The reagent of PG were made by TELLGEN CORPORATION company in Shanghai.The data of serum PG Ⅰ, PG Ⅱ and PG Ⅰ/PG Ⅱ of the normal control group(C), cirrhosis without PHG group(A),cirrhosis with mild PHG group(B),cirrhosis with mild PHG group(B1), cirrhosis with severe PHG group(B2) level of serum PG Ⅰ, PG Ⅱ level and PG Ⅰ/PG Ⅱ had be compared between any two groups by the SPSS 20.0 software program.Serum PG data according to the normal distribution test and f test analysis do not obey the normal distribution and variance of not neat,so the data belong to the non-normal distribution.We used the Kruskal Wallis H- inspection and multiple independent samples comparing two Nemenyi method to analyze data,and show the central tendency with Medians,the discrete trend with interquartile range(QR).Age data use the mean age ±standard.P < 0.05(double side) as the difference was statistically significant.Results: The levels of PG I in cirrhotic patients without PHG,the cirrhotic patients with mild PHG and the cirrhotic patients with severe PHG were lower than those in the healthy controls. The levels of PG I in the cirrhotic patients with server PHG were lower than those in the cirrhotic patients with mild PHG. In cirrhotic patients, the levels of PG II were lower than those in the healthy controls. The levels of PG II in the cirrhotic patients with server PHG were lower than in thecirrhotic patients without PHG. The Medians of the levels of PG I and PG II were being a downward trend in these four groups.Conclusion: In the clinical basis for determination of serum PG Ⅰ and PG Ⅱ can better to judge the PHG,and according to the concentration of serum PG on the different degree to carry on the preliminary assessment of the PHG and guide clinical treatment.