| 王俊先,束鹏,曹玉萍,等.消化性溃疡出血患者血清胃蛋白酶原和胃泌素水平的变化及临床意义[J].中国临床保健杂志,2021,24(4):498-501. |
| 消化性溃疡出血患者血清胃蛋白酶原和胃泌素水平的变化及临床意义 |
| Changes and clinical significance of serum pepsinogen and gastrin levels in patients with peptic ulcer hemorrhage |
| 投稿时间：2021-04-15 |
| DOI：10.3969/J.issn.1672-6790.2021.04.014 |
| 中文关键词: 消化性溃疡出血 胃泌素类 胃蛋白酶原类 预测 |
| 英文关键词: Peptic ulcer hemorrhage Gastrins Pepsinogens Forecasting |
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| 中文摘要: |
| 目的 观察消化性溃疡患者及消化性溃疡合并上消化道出血患者的血清胃泌素17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及PGⅠ/PGⅡ(PGR)水平变化情况,初步分析G-17及胃蛋白酶原(PG)对消化性溃疡合并上消化道出血的预测价值。方法 收集胃镜检查明确消化性溃疡且经14C呼气试验证实为幽门螺杆菌阳性的患者199例,其中单纯消化性溃疡(无合并上消化道出血)组107例,合并上消化道出血组92例。通过免疫荧光法检测血清PGⅠ、PGⅡ、G-17水平,并计算PGR,分析上述指标与消化性溃疡及出血的关系；通过受试者工作特征曲线(ROC曲线)分析PG及G-17评估消化性溃疡合并上消化道出血风险的特异性及敏感性。结果 消化性溃疡合并出血组患者血清G-17水平显著高于单纯消化性溃疡组(P＜0.05),而血清PGⅠ、PGⅡ及PGR各组之间差异均无统计学意义(P＞0.05)；在血清G-17升高(＞15 pmol/L)的消化性溃疡患者中,合并出血比例高于血清G-17正常或降低的患者(73.2%比27.4%,P＜0.05)；利用血清G-17水平预测消化性溃疡是否合并出血的ROC曲线下面积为0.866。敏感性为90.2%,特异性为68.2%。结论 在消化性溃疡合并出血患者血清中G-17水平明显升高,血清G-17水平预测消化性溃疡是否合并出血具有较高敏感性；PGⅠ、PG Ⅱ及PGR水平对消化性溃疡合并出血风险没有预测价值。 |
| 英文摘要: |
| Objective To observe the changes of serum levels of gastrin 17 (G-17),pepsinogen Ⅰ (PGⅠ),pepsinogen Ⅱ (PG Ⅱ) and PGⅠ/PG Ⅱ(PGR) in patients with peptic ulcer and patients with peptic ulcer complicated with upper gastrointestinal bleeding.The predictive value of G-17 and pepsinogen in peptic ulcer complicated with upper gastrointestinal bleeding was analyzed.Method A total of 199 patients with peptic ulcer confirmed by gastroscopy and Helicobacter pylori positive by 14C breath test were collected,including 107 patients with simple peptic ulcer and 92 cases complicated by upper gastrointestinal bleeding.Serum PGⅠ,PGⅡ and G-17 levels were detected by immunoassay,and PGR was calculated.The differences between the groups were compared to analyze the relationship between the above indexes and peptic ulcer and bleeding.Receiver operating characteristic curve (ROC) was used to analyze the specificity and sensitivity of PG and G-17 in assessing the risk of peptic ulcer complicated with upper gastrointestinal bleeding.Results The serum G-17 level in the peptic ulcer complicated with hemorrhage group was significantly higher than that in the simple peptic ulcer group (P＜0.05),but there was no statistical significance in the serum PGⅠ,PGⅡ and PGR among all groups (P＞0.05).In peptic ulcer patients with elevated serum G-17 (upper limit of normal value at 15 pmol/L),the rate of complicated bleeding was higher than that in patients with normal or decreased serum G-17 (73.2% vs.27.4%,P＜0.05).The area under the ROC curve for predicting peptic ulcer complicated with bleeding by serum G-17 level was 0.866.The sensitivity and specificity were 90.2% and 68.2% respectively.Conclusions Serum G-17 level is significantly increased in peptic ulcer patients complicated with hemorrhage,and serum G-17 level is highly sensitive to predict whether peptic ulcer complicated with hemorrhage.The levels of PGⅠ,PGⅡ and PGR have no predictive value on the risk of peptic ulcer complicated with bleeding. |
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