慢性酒精性和非酒精性胰腺炎患者不同胃肠激素水平分析  

The Analysis of Different Gastrointestinal Hormones in Alcoholic Pancreatitis

作　　者：程征宇[1] 钟显飞[1] 邓学杰[1] 王琴[1] 刘慧娟[1] CHENG Zheng-yu;ZHONG Xian-fei;DENG Xue-jie;WANG Qin;LIU Hui-juan(Department of Gastroenterology,Le Shan People Hospital of Sichuan Province,Leshan 614000,China)

机构地区：[1]乐山市人民医院消化内科

出　　处：《微循环学杂志》2019年第4期36-39,42,共5页Chinese Journal of Microcirculation

摘　　要：目的:分析慢性酒精性胰腺炎(ARP)和慢性非ARP患者胃饥饿素(Gh)、胃泌素释放多肽(GRP)和血管活性肠肽(VIP)水平及临床应用价值。方法:本院2018-01—2018-12收治的慢性胰腺炎患者共82例,依据病因分为ARP组(33例)和非ARP组(49例)。采用ELISA检测两组患者血清Gh、GRP和VIP三种胃肠激素以及胰蛋白酶和胰糜蛋白酶两种胰酶水平并比较两组间各指标的差异。应用Pearson线性相关分析Gh、GRP、VIP与胰蛋白酶和胰糜蛋白酶水平的相关性。应用ROC曲线分析Gh、GRP、VIP、胰蛋白酶和胰糜蛋白酶对ARP的诊断价值。采用Logistic回归分析Gh、GRP和VIP水平与ARP的关系。结果:ARP组血清Gh水平明显高于非ARP组(9.33±4.21ng/ml vs 6.61±3.98ng/ml,P<0.01)。Pearson相关性分析提示Gh与胰蛋白酶和胰糜蛋白酶水平均呈正相关,相关系数分别为0.495、0.451(P<0.01)。ROC曲线提示Gh对于ARP的诊断意义最高,AUC为0.807,95%CI为0.745-0.870,cut-off值为12.43ng/ml,敏感度82.12%,特异度84.61%。Losgistic回归分析提示Gh>12.43ng/ml(模型1:OR=1.55,95%CI 1.06—1.95;模型2:OR=1.87,95%CI 1.12—2.35,P均<0.05)为ARP的独立危险因素。结论:ARP患者Gh水平明显升高,该指标有助于ARP的诊断,是ARP的独立危险因素。Objective:To evaluate the different of ghrelin(Gh),gastrin-releasing paptide(GRP)and vasoactive intestinal peptide(VIP)between alcoholic chronic pancreatitis(ARP)and non-alcoholic chronic pancreatitis patients.Method:Eighty-two chronic pancreatitis were enrolled in this study and divided into ARP group(n=33)and non-ARP group(n=49).The serum levels of three gastrointestinal hormones(Gh,GRP and VIP)and pancreatin(trypsin and chymotrypsin)were measured by ELISA and analyzed the difference between each groups.Pearson correlation analysis was used to evaluate the relation between gastrointestinal hormones(Gh,GRP and VIP)and pancreatin(trypsin and chymotrypsin).ROC analysis was used to evaluate the diagnosis value of gastrointestinal hormones(Gh,GRP and VIP)and pancreatin(trypsin and chymotrypsin)for ARP.Logistic regression was used to evaluate the relationship between gastrointestinal hormones(Gh,GRP and VIP)and pancreatin(trypsin and chymotrypsin).Results:The levels of Gh in ARP group were higher than those in non-ARP group(9.33±4.21ng/ml vs 6.61±3.98ng/ml,P<0.001).Pearson correlation analysis showed that Gh was positively related with trypsin and chymotrypsin,which relation index were 0.495,0.451,respectively.ROC analysis suggested that Gh was the most valueable index for ARP diagnosis,which AUC value was 0.807and cut-off value was 12.43ng/ml,the sensitivity was 82.12%,the specificity was 84.61%.Losgistic regression analysis indicated that Gh was an indepansive risk factor of ARP,which OR value were 1.55and 1.87in model 1and 2,respectively.Conclusion:The levels of serum Gh is significantly increased in ARP patients,which is helpful for ARP diagnosis.Gh is an indepansive risk factor for ARP.

关 键 词：酒精性胰腺炎 胃饥饿素 胃泌素释放多肽 血管活性肠肽 胰蛋白酶 胰糜蛋白酶 

分 类 号：R576[医药卫生—消化系统]