空腹血清胃蛋白酶原和胃泌素-17对萎缩性胃炎的诊断价值  

Diagnostic value of serum pepsinogen and gastrin-17 in patients with atrophic gastritis

作　　者：蒋振华[1] 丁辉[1] 崔艳霞[1] 黄宇博[1] 杨帆[1] 李修岭[1] 晁帅恒 李毅[1] Jiang Zhenhua Ding Hui Cui Yanxia Huang Yubo Yang fan Li Xiuling Chao Shuaiheng Li Yi.(Department of Gastroenterology, Zhengzhou University People＇s Hospital, Zhengzhou 450003, Chin)

机构地区：[1]郑州大学人民医院(河南省人民医院)消化内科,郑州450003

出　　处：《中华胃肠内镜电子杂志》2016年第3期112-115,共4页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

基　　金：国家科技支撑计划(2015BAI13B08)

摘　　要：目的评价空腹血清胃蛋白酶原(FsPG)和胃泌素-17(FsG-17)对萎缩性胃炎的诊断价值。方法将河南省人民医院自2016年3月至2016年7月经内镜或病理诊断的慢性萎缩性胃窦炎和慢性萎缩性胃体炎各26例和16例设为观察组,将与两组样本量相同,年龄、性别、幽门螺杆菌(Hp)感染情况相似的经内镜诊断为非萎缩性胃炎的患者设为对照组。用酶联免疫法对四组患者行FsPG和FsG-17检测,计算PGI/PGII值(PGR),比较两组间FsPGI、FsPGII和FsG-17水平以及FsPGR值。根据结果选择有意义的指标做ROC曲线,确定最佳临界值及其所对应的灵敏度和特异度。结果胃窦萎缩组FsG-17低于对照组,差异有统计学意义[2.37(0.68,3.93)pmol/L vs 7.69(5.45,-16.82)pmol/L,P<0.01];两组间FsPGI[(126.70±64.70)μg/L vs(178.82±116.43)μg/L,P=0.55]、FsPGII[(9.21±4.97)μg/L vs(16.26±13.05)μg/L,P=0.15]和FsPGR[12.62(10.19,18.69)vs 11.16(8.05,16.90),P=0.26]差异无统计学意义。胃体萎缩组其FsPGI[(116.28±80.43)μg/L vs(140.33±100.33)μg/L,P=0.46]、FsPGII[(12.13±12.17)μg/L vs(17.64±15.57)μg/L,P=0.27]、FsPGR[(11.98±7.36)μg/L vs(8.95±4.05)μg/L,P=0.16]和FsG-17[6.45(2.81,12.16)vs 5.35(1.77,9.48),P=0.42]与其对照组差异无统计学意义。根据胃窦萎缩组与其对照组FsG-17水平绘制ROC曲线,其曲线下面积(AUC)分别为0.840±0.057,在其取最佳临界值4.60 pmol/L时,所对应灵敏度为80.8%,特异度为84.6%。结论 FsG-17可用来检测胃窦萎缩,目前数据尚不能证明FsPG和FsG-17对胃体萎缩有诊断价值。Objective To evaluate the value of serum pepsinogen（ PG） and gastrin-17（ G-17） in the diagnosis of patients with atrophic gastritis. Methods All of the observation group and control group were collected in the Henan Provincial People＇s Hospital during March to July in 2016. The two observation groups possessing 26 and 16 patients diagnosed with atrophic antral gastritisand atrophic corpus gastritis by endoscopy or pathology. The corresponding control groups were made up of the patients in the same period with similar age,gender,and the condition of helicobacter pylori（ Hp） infection. The fasting serum PG（ FsPG） and G-17（ FsG-17） were detected via ELISA for 4 groups and the PGI/PGII ratio（ PGR） was calculated. Fasting serum PGI,PGII,PGR and G-17 were compared between the two observation groups and their corresponding control groups. ROC curve was drawn according to the comparative results and the best critical value together with the corresponding sensitivity and specificity were calculated. Results The FsG-17 between the atrophic antral gastritis and its control group had reached the statistical difference[2. 37（ 0. 68,3. 93） pmol/L vs 7. 69（ 5. 45,16. 82） pmol/L,P 0. 01]. While the FsPGI [（ 126. 70 ±64. 70） μg / L vs（ 178. 82 ± 116. 43） μg / L,P = 0. 55 ],FsPGII [（ 9. 21 ± 4. 97） μg / L vs（ 16. 26 ±13. 05） μg / L,P = 0. 15],FsPGR [12. 62（ 10. 19,18. 69） vs 11. 16（ 8. 05,16. 90）,P = 0. 26] between the two groups did not. There were no statistical difference in FsPGI[（ 116. 28 ± 80. 43） μg / L vs（ 140. 33 ±100. 33） μg / L,P = 0. 46],FsPGII[（ 12. 13 ± 12. 17） μg / L vs（ 17. 64 ± 15. 57） μg / L,P = 0. 27],FsPGR[（ 11. 98 ± 7. 36） μg/L vs（ 8. 95 ± 4. 05） μg/L,P = 0. 16] and FsG-17[6. 45（ 2. 81,12. 16） vs 5. 35（ 1. 77,9. 48）,P = 0. 42]between the atrophic corpus gastritis and its control group. Draw the ROC curve on the basis of the FsG-17 of the atrophic antral gastritis and its control group. According to the

关 键 词：萎缩性胃炎 胃蛋白酶原 胃泌素-17 诊断价值 

分 类 号：R573.32[医药卫生—消化系统]