唾液中胃蛋白酶检测对非典型GERD的诊断价值探讨  

Diagnostic Value of the Detection of Pepsin in the Saliva to the Atypical GERD

作　　者：薛法义[1] 郑创益[1] 

机构地区：[1]漯河市第三人民医院口腔科,河南漯河462000

出　　处：《口腔医学研究》2012年第7期705-708,共4页Journal of Oral Science Research

摘　　要：目的:胃食管反流病(GERD)的非典型表现多种多样,本研究致力于观察是否可通过检测唾液中的胃蛋白酶来辅助诊断非典型GERD。方法:收集疑似GERD病人的唾液,收集时间为夜间睡前,症状发做时,晨起后,用蛋白印迹法检测其中的胃蛋白酶。所有病例接受24h食管pH值监测,然后,口服40mg/次埃索美拉唑,2/d,持续两周。结果:40名病人中,20名胃蛋白酶检测阳性,主要是症状发作时采集的唾液样本呈阳性,(45%)健康对照组八名全部阴性,24hpH监测阳性者9人(23%)以24hpH为金标准,则胃蛋白酶检测的敏感性和阴性预测值较为理想。然而,特异性和阳性预测值欠佳。结论:收集GERD非典型症状患者症状发作时的唾液,检测其中的胃蛋白酶,为疑似GERD患者提供了一种敏感、非侵入性检查方法。Objective： To determine whether pepsin detection in the saliva could be useful for diagnosing GERD in patients with clinically suspected atypical GERD symptoms. Methods： Patients with clinically suspected atypical GERD symptoms provided saliva collected before bedtime, at the time of those symptoms, and after awakening for pepsin measurement by Western blot analysis. All subjects received 24--hour esophageal pH monitoring, and then 40rag of esomeprazole was given twice a day for 2 weeks. Results： The pepsin test was positive in 20 out of 40 pa- tients, with pepsin detected mainly in the samples collected at the time of symptoms （45%）. Samples collected from healthy volunteers （n = 8） were all negative for pepsin. 24 -- hour pH -- merry was positive in 9 patients （23%）. Based on 24--hour pH--metry data, the sensitivity and negative predictive value of the pepsin test were excellent in most of typical and atypical symptom groups, whereas its specificity and positive predictive value were relatively low, particularly in atypical symptom groups. Conclusion： Pepsin measurement in the saliva collected at the time of symptoms provides a sensitive, non--invasive method for diagnosing GERD in patients with clinically suspected atypical GERD symptoms.

关 键 词：GERD 胃蛋白酶 食管PH值监测 PPI试验 

分 类 号：R571[医药卫生—消化系统]