GPDA、BUN及Cr在消化道出血患者中的水平及意义  

The Level and Significance of GPDA,BUN and Cr in Patients with Gastrointestinal Bleeding

作　　者：李珍艳 杨小莉[1] 李罗红[1] 李小琼[1] 欧艳[1] 陈莎[1] 雷娜[1] Yang Xiaoli;Li Luohong(Department of Gastroenterology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院消化内科,四川成都610041

出　　处：《四川医学》2020年第6期593-596,共4页Sichuan Medical Journal

摘　　要：目的探讨甘氨酰脯氨酸二肽氨基酸(GPDA)、尿素氮(BUN)及肌酐(Cr)在消化道出血患者中的水平及意义。方法选取2018年1月至2019年1月在我院治疗的消化道出血患者154例(出血组),其中上消化道出血67例,下消化道出血87例,同时选取健康体检者154例作为对照组,检测GPDA、BUN及Cr水平。结果出血组GPDA为(45.51±12.03) U/L,明显低于对照组,而BUN、Cr分别为(8.87±2.03) mmol/L和(85.52±11.03) mol/L,明显高于对照组,差异有统计学意义(P<0.05);上消化道出血患者GPDA为(38.84±10.12) U/L,明显低于下消化道患者,而BUN为(10.69±2.15) mmol/L,明显高于下消化道患者,差异有统计学意义(P<0.05);上下消化道出血患者Cr比较,差异无统计学意义(P>0.05);GPDA、BUN判断上消化道出血的ROC曲线下面积分别为0.733和0.879,95%CI分别为:0.634~0.831和0.811~0.946,P<0.05,截断值分别45.11 U/L和9.04 mmol/L,P<0.05,灵敏性分别为68.00%和84.00%,特异性分别为76.00%和84.00%。结论消化道出血患者GPDA明显降低,而BUN、Cr明显升高,其中GPDA、BUN水平在鉴别上下消化道出血方面有一定应用价值。Objective To investigate the level and significance of glycylproline dipeptide amino acid (GPDA),blood urea nitrogen (BUN) and creatinine (Cr) in patients with gastrointestinal bleeding. Methods From January 2018 to January 2019,154 patients with gastrointestinal bleeding treated in our hospital (bleeding group) were selected,including 67 cases of upper gastrointestinal bleeding and 87 cases of lower gastrointestinal bleeding.At the same time,154 healthy people were selected as the control group to detect the levels of GPDA,BUN and Cr.Results GPDA was (45. 51±12. 03) U/L in the bleeding group,which was significantly lower than that in the control group,while BUN and Cr were (8. 87±2. 03) mmol/L and (85. 52±11. 03) mol/L,respectively,which was significantly higher than that in the control groupwith statistically significant difference (P<0. 05).The GPDA of patients with upper gastrointestinal bleeding was (38. 84±10. 12) U/L,which was significantly lower than that of patients with lower gastrointestinal tract,while the BUN was (10. 69±2. 15) mmol/L,which was significantly higher than that of patients with lower gastrointestinal tractwith statistically significant difference (P<0. 05).In patients with upper and lower gastrointestinal hemorrhage,the difference in Cr was not statistically significant (P>0. 05).The area under the ROC curve for GPDA and BUN to judge upper gastrointestinal bleeding was 0. 733 and 0. 879.And 95%CI were 0. 634 ~ 0. 831 and 0. 811 ~ 0. 946 (P< 0. 05).Cutoff values were45. 11 U/L and 9. 04 mmol/L (P < 0. 05). Sensitivity were 68. 00% and 84. 00%,and specificity were 76. 00% and 84. 00% respectively.Conclusion The GPDA of patients with gastrointestinal hemorrhage is significantly reduced,while BUN and Cr are significantly increased.Among them,the levels of GPDA and BUN have certain application value in identifying upper and lower gastrointestinal hemorrhage.

关 键 词：甘氨酰脯氨酸二肽氨基酸 尿素氮 肌酐 消化道出血 

分 类 号：R573.2[医药卫生—消化系统]