空腹血清胃蛋白酶原和胃泌素-17对反流性食管炎的诊断价值  

Value of fasting serum pepsinogen and gastrin-17 to the diagnosis of reflux esophagitis

作　　者：蒋振华[1] 李修岭[1] 杨帆[1] 黄宇博[1] 崔艳霞[1] 马曼茹 孟琳琳[1] 

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：《中华实用诊断与治疗杂志》2017年第1期39-41,共3页Journal of Chinese Practical Diagnosis and Therapy

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(fasting serum pepsinogen,FsPG)和胃泌素-17(fasting serum gastrin-17,FsG-17)对反流性食管炎的诊断价值。方法经内镜检查确诊反流性食管炎38例为观察组,非食管器质性病变患者38例为对照组,采用ELISA法检测2组血清FsPG和FsG-17水平,计算FsPGⅠ/FsPGⅡ(FsPG ratio,FsPGR)值,并进行2组间比较;绘制ROC曲线,分析FsPG和FsG-17对反流性食管炎的诊断价值;比较洛杉矶(Los Angeles,LA)A级和LA B级患者FsG-17水平。结果观察组FsG-17水平[1.82(0.82,8.49)pmol/L]高于对照组[1.13(0.47,2.53)pmol/L](P<0.05),FsPGⅠ[(146.19±89.91)μg/L]、FsPGⅡ[7.41(4.87,13.82)μg/L]、FsPGR(13.52±5.15)与对照组[(128.60±76.80)μg/L、7.89(5.35,19.69)μg/L、16.53±10.26]比较差异无统计学意义(P>0.05);观察组中LA A级患者FsG-17水平[(6.66±8.68)pmol/L]与LA B级[(7.76±12.19)pmol/L]比较差异无统计学意义(P>0.05);ROC曲线分析结果显示,FsG-17用于诊断反流性食管炎的最佳临界值为5.27pmol/L,敏感度为31.6%,特异度为97.3%。结论 FsPG对反流性食管炎无诊断价值;反流性食管炎患者FsG-17水平升高与疾病程度可能无关;FsG-17诊断反流性食管炎的敏感度较低,不适合用于临床筛查。Objective To evaluate the value of fasting serum pepsinogen （FsPG） and fasting gastrin-17 （FsG-17） to the diagnosis of reflux esophagitis （RE）. Methods The FsPG and FsG-17 levels were detected by ELISA and the PG Ⅰ/PG Ⅱ ratio was calculated and compared between 38 patients with endoscopically diagnosed RE （observation group） and 38 patients without organic esophageal disease （control group）. The ROC curve was drawn. The diagnostic value of FsPG and FsG-17 was analyzed, and the difference of FsG-17 level was compared between Los Angeles （LA） A group and LAB group. Results The FsG-17 level was significantly higher in observation group （（1.82（0.82-8.49） pmol/L） than that in control group （（1.13（0.47-2.53） pmol/L） （P〈0.05）. The levels of FsPGI （（146. 19±89.91） μg/L）, FsPG Ⅱ （7.41 （4.87-13.82） μg/L） and FsPG ratio （13.52 ± 5.15） in observation group showed no significant differences in comparison with control group （（128.60±76.80） μg/L, 7.89（5.35-19.69） 9g/L, 16.53±10.26） （P〉0. 05）. There was no significant difference in the FsG-17 level between LA A group （（6.66±8.68）pmol/L） and LA B group （（7.76± 12.19） pmol/L） （P〉0.05）. The best cut-off point of FsG-17 for diagnosing RE was 5.27 pmol/L, while the sensitivity and specificity were 31.6% and 97.3%. Conclusion FsPG is of no value to the diagnosis of RE. The increased FsG-17 level is probably not correlated with RE degree. Owing to the limited sensitivity of FsG-17 for diagnosing RE, it is not yet suitable for clinical screening.

关 键 词：反流性食管炎 胃蛋白酶原 胃泌素-17 诊断价值 

分 类 号：R571[医药卫生—消化系统]