血清胃蛋白酶原对儿童消化性溃疡诊断价值的研究  

Value of serum pepsinogen in diagnosing children peptic ulcer

作　　者：林琼[1] 王叶红[1] 唐国荣[1] 金玉[1] 

机构地区：[1]南京医科大学附属无锡市儿童医院消化科,214023

出　　处：《中国医药》2016年第3期424-427,共4页China Medicine

基　　金：江苏省无锡市卫生和计划生育委员会科研项目（MU201427）

摘　　要：目的 探讨血清胃蛋白酶原（PG）Ⅰ、Ⅱ水平及二者比值对儿童消化性溃疡（PU）的临床诊断价值.方法 选取2012年11月至2014年10月南京医科大学附属无锡市儿童医院因腹痛、呕吐等上消化道症状就诊的129例患儿为研究对象,通过胃镜检查明确诊断PU者57例（PU组）、胃炎者72例（胃炎组）;以同期健康体检儿童47名为对照组.PU组、胃炎组、对照组所有儿童分别抽取静脉血,采用时间分辨荧光免疫分析法检测血清PG Ⅰ、PGⅡ水平和PG Ⅰ/PGⅡ比值,分析血清PG Ⅰ、PGⅡ水平诊断儿童PU的效能.结果 PU组、胃炎组及对照组血清PG Ⅰ水平分别为197.0（147.0,265.0）、105.0（85.5,137.0）、83.0（69.0,106.0）μg/L,两两比较差异均有统计学意义（均P＜0.05）;PU组、胃炎组及对照组血清PGⅡ水平分别为14.1（9.8,22.8）、7.6（5.7,10.2）、7.0（4.9,10.7）μg/L,PU组与对照组、胃炎组比较差异均有统计学意义（均P ＜0.05）,而对照组与胃炎组之间比较差异无统计学意义（P ＞0.05）;PU组、胃炎组、对照组PG Ⅰ/PGⅡ比值两两比较差异均无统计学意义（均P＞0.05）.绘制受试者工作特征（ROC）曲线,血清PG Ⅰ水平诊断儿童PU的ROC曲线下面积为0.838,以PG Ⅰ＞152 μg/L为诊断儿童PU的界值,其敏感度为73.7％、特异度为84.7％;血清PGⅡ水平诊断儿童PU的ROC曲线下面积为0.810,以PGⅡ＞8.8 μg/L为诊断儿童PU的界值,其敏感度为82.5％、特异度为69.4％;血清PG Ⅰ、PGⅡ水平诊断儿童PU的ROC曲线下面积比较,差异无统计学意义（P＞0.05）.结论 儿童血清PG Ⅰ、PGⅡ水平明显升高,提示患PU的风险增加,血清PG水平检测对儿童PU的筛查、诊断均有一定临床意义,可以作为辅助诊断儿童PU的筛查指标之一.Objective To investigate the value of serum pepsinogen （PG） Ⅰ,PG Ⅱ,ratio of PG Ⅰ/PG Ⅱ in diagnosing children peptic ulcer （PU）.Methods Totally 129 children with digestive tract symptoms were enrolled,among them,57 cases were diagnosed as PU （PU group） and 72 cases were diagnosed as gastritis （gastritis group）;47 healthy children were as control group.The levels of PG [and PG Ⅱ] in serum were measured by time-resolved flurescence immunoassay,the ratio of PG Ⅰ/PG Ⅱ was calculated and compared between groups.Results The serum PG Ⅰ level in PU group,gastritis group and control group was respectively 197.0 （147.0,265.0）,105.0 （85.5,137.0）,83.0 （69.0,106.0） μg/L;there were significant differences between groups （all P 〈 0.05）.The serum PG Ⅱ level in PU group,gastritis group and control group was respectively 14.1 （9.8,22.8）,7.6 （5.7,10.2）,7.0 （4.9,10.7） μg/L;there were significant differences between PU group and gastritis group,PU group and control,no significant difference was found between gastritis group and control group （P 〉 0.05）.The ratio of PG Ⅰ/PG Ⅱ showed no significant differences among groups （all P 〉 0.05）.In receiver operating characteristic curve,the area under curve of PG Ⅰ and PG Ⅱ was 0.838 and 0.810,respectively,with no significant difference （P 〉 0.05）;taking 152 μg/L as cut-off value of PG Ⅰ,the sensitivity and specificity in diagnosing PU was 73.7% and 84.7%;taking 8.8 μg/L as cut-off value of PG Ⅱ,the sensitivity and specificity in diagnosing PU was 82.5% and 69.4%.Conclusion The high levels of PG Ⅰ and PG Ⅱ in serum indicate a high risk of peptic ulcer in children;detection of PG in serum is non invasive,which is useful for screening and diagnosing PU in children.

关 键 词：消化性溃疡 胃蛋白酶原 儿童 

分 类 号：R573.1[医药卫生—消化系统]