| 特集名 | ペプシノゲン -- 基礎，臨床応用，疫学 | |
|---|---|---|
| 題名 | 臨床応用 (5) ペプシノゲン法とその他の消化管疾患 | |
| 発刊年月 | 2002年 10月 | |
| 著者 | 隅井 浩治 | 済生会広島病院内科 |
| 【 要旨 】 | 血清ペプシノゲンとくにPG Iは酸分泌とほぼ相関するが，異常高値と異常低値で臨床的意義がある．異常高値では酸分泌も高値で十二指腸潰瘍，胃十二指腸併存潰瘍，前庭部胃潰瘍などの可能性が高く，異常低値では酸分泌も低値で悪性貧血，胃癌，胃腺腫，胃過形成性ポリープなどが疑われる．消化性潰瘍では潰瘍素因と潰瘍再発のマーカーとして意義がある．十二指腸潰瘍と高PG I血症，胃体部胃潰瘍とPGC(PG II)遺伝子のRFLPで関連性があり，消化性潰瘍の素因のマーカーといえる．高PG I血症を示す十二指腸潰瘍では再発率が高く，低PG I血症では再発率が低い． しかし，ペプシノゲンはH.pylori感染により影響を受けるので，これらはいずれも未除菌例においてのみ評価可能である． |
|
| Theme | Pepsinogen -- Basic, Clinical Implications, and Epidemiology | |
|---|---|---|
| Title | Pepsinogens and Their Relation to Gastroduodenal Diseases Other than Gastric Cancer | |
| Author | Koji Sumii | Saiseikai Hiroshima Hospital |
| [ Summary ] | Serum pepsinogen I (PG I) levels are related to gastric acid secretion. A marked increase in PG I was noted in patients with duodenal ulcers, gastroduodenal ulcers or gastric ulcers (antrum). A marked decrease was noted in patients with pernicious anemia, gastric cancer, adenoma and gastric polyps. Pepsinogens were useful as markers for ulcer diathesis. In familial studies, hyper-PG I was considered to be a subclinical marker for duodenal ulcer diathesis, and the RFLP of PGC (PG II) was suggested as a genetic marker for gastric ulcer (body) diathesis. PG I levels were suitable markers for selecting patients at high risk for duodenal ulcer recurrence. The recurrence rates for duodenal ulcers was high in patients with hyper-PG I, and low for patients with low-PG I. It was the same in gastric ulcer cases. Serum pepsinogen levels of those were affected by H.pylori infections, were useful as subclinical markers only in patients who did not receive eradication therapy for H.pylori. |
|