唾液胃蛋白酶检测对胃食管反流病的诊断价值  

Diagnostic value of pepsin in saliva for gastroesophageal reflux disease

作　　者：郭子皓[1] 陈婧[1] 郭宝娜[1] 杨彬彬[2] 李莉[1] 姜佳丽[1] 王凝[1] 展玉涛[1] 张川[1] GUO Zihao;CHEN Jing;GUO Baona;YANG Binbin;LI Li;JIANG Jiali;WANG Ning;ZHAN Yutao;ZHANG Chuan(Department of Gastroenterology;Department of Central Laboratory,Beijing Tong Ren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院消化内科,北京100730 [2]首都医科大学附属北京同仁医院中心实验室,北京100730

出　　处：《胃肠病学和肝病学杂志》2019年第11期1229-1232,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：北京市医管局消化协同中心特色项目(XXT09)

摘　　要：目的探讨唾液中胃蛋白酶水平对胃食管反流病(gastroesophageal reflux disease,GERD)的诊断价值。方法纳入GERD症状评分>8分的患者,依据胃镜检查及24 h食管pH-阻抗监测结果,将患者分为GERD组和非GERD组,依据食管高分辨测压分为食管动力减退亚组和食管动力正常亚组。收集各组患者的唾液,应用酶联免疫吸附法进行胃蛋白酶检测。结果GERD组50例,非GERD组68例,空腹唾液胃蛋白酶含量分别为(11.4±2.3)ng/ml及(5.6±1.4)ng/ml,两组比较,差异有统计学意义(P<0.05)。食管动力减退亚组及食管动力正常亚组的唾液胃蛋白酶含量差异无统计学意义(P>0.05)。以空腹唾液胃蛋白酶含量>3.6 ng/ml为诊断标准,诊断GERD的敏感性为72.0%,特异性为76.0%。结论唾液中胃蛋白酶浓度的检测可辅助诊断GERD,食管动力对唾液胃蛋白酶含量无影响。Objective To investigate the diagnostic value of pepsin in saliva for gastroesophageal reflux disease(GERD).Methods Patients with GerdQ score≥8 points were included.Patients were divided into GERD group and non-GERD group according to endoscopy and 24-hour esophageal pH-impedance monitoring.Patients were divided into normal motor subgroup and abnormal motor subgroup according to high-resolution manometry.The saliva of patients in each group was collected for pepsin detection by enzyme-linked immunosorbent assay.Results The saliva pepsin concentration in GERD group(n=50)and non-GERD group(n=68)were(11.4±2.3)ng/ml and(5.6±1.4)ng/ml,respectively,there was significant difference between two groups(P<0.05).There was no significant difference in the level of pepsin in saliva between normal motor subgroup and abnormal motor subgroup(P>0.05).The sensitivity and specificity of the diagnosis of GERD were 72.0%and 76.0%,respectively,when the content of pepsin in fasting saliva was more than 3.6 ng/ml as the diagnostic standard.Conclusion Pepsin in saliva is a helpful tool for GERD diagnosis,and esophageal motility has no effect on the concentration of pepsin in saliva.

关 键 词：胃食管反流病 唾液 胃蛋白酶 诊断 

分 类 号：R571[医药卫生—消化系统]