目的 探讨慢性萎缩性胃炎（chronic atrophic gastritis，CAG）病理改变与幽门螺旋杆菌（Heli⁃cobacter Pylori，Hp）感染、血清胃蛋白酶原、胃泌素⁃17 的相关性。方法 选取127 例病理诊断为CAG 患者，14C 呼气试验检测Hp，ELISA检测血清PGI、PGII、G⁃17水平，比较不同病理特征与Hp 感染及血清PGI、PGII、PGR、G⁃17 的关系，并绘制ROC 曲线，评价其诊断价值。结果 CAG 组Hp 感染率较高，血清PGI、PGII、PGR、G⁃17下降，胃粘膜萎缩程度越重，血清PGI、PGII、PGR、G⁃17水平下降越明显。Hp 感染阳性者以中度炎症和中度萎缩为主。经PGI、PGII、PGR、G⁃17 绘制CAG 的ROC 曲线下面积分别为0.981、0.795、0.800 和0.661，具有较高的诊断性能。结论 联合检测Hp 及PG、G⁃17 能提高萎缩性胃炎的诊断性能，有助于对胃黏膜萎缩程度风险分层和早期诊断。

Objective To investigate the correlations between pathological changes and helicobacter pyloriinfection，serum pepsinogen and gastrin⁃17 of chronic atrophic gastritis（CAG）. Methods 127 patients with CAGwere enrolled in the study. Their serum levels of PGI，PGII，G ⁃17 and Hp were detected by 14C⁃UBT test andELISA. ROC curve was drawn to evaluate its diagnostic value. Results The infection rate of Hp was higher，andthe serum levels of PGI，PGII，PGR and G⁃17 decreased in the CAG group. The more severe the gastric mucosa at⁃rophy was，the more remarkably the serum levels of PGI，PGII，PGR and G⁃17 decreased. Moderate inflammationand moderate atrophy were predominant in the Hp ⁃infected patients. The area under the ROC curve of CAG was0.981，0.795，0.800 and 0.661 by PGI，PGII，PGR and G⁃17，respectively. Conclusion The combined test ofHp，PG and G⁃17 can improve the affirmative diagnose of atrophic gastritis，and it helps to stratify the atrophy riskand make early diagnosis of gastric mucosa atrophy.