血清胃泌素、C反应蛋白和肿瘤坏死因子α与消化性溃疡出血程度的相关性分析  

Correlation of serum gastrin,C-reactive protein and tumor necrosis factorαwith the degree of peptic ulcer bleeding

作　　者：汪志刚 李爱珍 李春霞 Wang Zhigang;Li Aizhen;Li Chunxia(Department of Gastroenterology,Hangzhou Hospital of Zhejiang Medical Health Group,Hangzhou 310000,China)

机构地区：[1]浙江省医疗健康集团杭州医院消化内科,杭州310000

出　　处：《中国医师进修杂志》2023年第1期68-73,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨血清胃泌素、C反应蛋白(CRP)和肿瘤坏死因子α(TNF-α)与消化性溃疡出血程度的相关性。方法回顾性分析浙江省医疗健康集团杭州医院2019年4月至2020年9月90例消化性溃疡出血患者(试验组)的临床资料,其中Blatchford评分低危15例,中危40例,高危35例;另外选取同期40例健康体检者作为对照组。采用酶联免疫吸附试验法检测血清CRP和TNF-α水平,放射免疫法检测血清胃泌素水平。采用Pearson法行CRP、TNF-α和胃泌素与Blatchford评分的相关性分析;采用多因素Logistic回归分析影响高危消化性溃疡出血的独立危险因素;采用受试者工作特征(ROC)曲线分析CRP、TNF-α和胃泌素预测高危消化性溃疡出血的价值。结果试验组CRP、TNF-α和胃泌素均明显高于对照组[(19.69 ± 3.41) mg/L比(2.28 ± 0.64) mg/L、(26.63 ± 4.24) ng/L比(1.35 ± 0.31) ng/L和(149.77 ± 21.41) μg/L比(72.65 ± 12.39) μg/L],差异有统计学意义(P<0.01)。中危和高危患者血红蛋白和血小板明显低于低危患者[(59.21 ± 4.63)和(28.94 ± 4.69) g/L比(89.68 ± 5.12) g/L、(162.14 ± 12.47)和(122.05 ± 10.39) × 109/L比(213.58 ± 16.98) × 109/L],高危患者明显低于中危患者,差异有统计学意义(P<0.05);中危和高危患者凝血酶原时间、CRP、TNF-α和胃泌素明显高于低危患者[(13.98 ± 1.29)和(16.97 ± 1.15)s比(11.00 ± 2.07)s、(18.87 ± 4.68)和(22.69 ± 2.96) mg/L比(15.45 ± 5.54) mg/L、(27.43 ± 5.05)和(31.02 ± 4.56) ng/L比(21.39 ± 8.54) ng/L、(140.89 ± 22.36)和(160.58 ± 25.52) μg/L比(121.39 ± 15.17) μg/L],高危患者明显高于中危患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血红蛋白、血小板、CRP、TNF-α和胃泌素为影响高危消化性溃疡出血的独立危险因素(OR = 0.224、0.321、3.687、3.058和4.051,95%CI 0.004~0.894、0.121~8.547、1.912~5.525、3.012~10.609和2.012~7.525,P<0.05或<0.01)。Pearson相关分析结果显示,CRP、TNF-α和胃Objective To investigate the correlation between serum gastrin,C-reactive protein(CRP),tumor necrosis factorα(TNF-α)and the degree of peptic ulcer bleeding.Methods The clinical data of 90 peptic ulcer bleeding patients(test group)from April 2019 to September 2020 in Hangzhou Hospital of Zhejiang Medical and Health Group were retrospectively analyzed,including 15 cases with low-risk,40 cases with intermediate-risk and 35 cases with high-risk of Blatchford score;40 physical examination volunteers were selected as the control group during the same period.The serum levels of CRP and TNF-αwere measured by enzyme-linked immunosorbent assay,and the serum level of gastrin was measured by radioimmunoassay.The correlation between CRP,TNF-α,gastrin and the Blatchford score was analyzed by Pearson method;the independent risk factors affecting high-risk peptic ulcer bleeding were analyzed by multivariate Logistic regression;the value of CRP,TNF-αand gastrin in predicting high-risk peptic ulcer bleeding was analyzed by the receiver operating characteristic(ROC)curve.Results The CRP,TNF-αand gastrin in test group were significantly higher than those in control group:(19.69±3.41)mg/L vs.(2.28±0.64)mg/L,(26.63±4.24)ng/L vs.(1.35±0.31)ng/L and(149.77±21.41)μg/L vs.(72.65±12.39)μg/L,and there were statistical differences(P<0.01).The hemoglobin and platelets in intermediate-risk and high-risk patients were significantly lower than those in low-risk patients:(59.21±4.63)and(28.94±4.69)g/L vs.(89.68±5.12)g/L,(162.14±12.47)and(122.05±10.39)×109/L vs.(213.58±16.98)×109/L,the indexes in high-risk patients were significantly lower than those in intermediate-risk patients,and there were statistical differences(P<0.05);the prothrombin time,CRP,TNF-αand gastrin in intermediate-risk and high-risk patients were significantly higher than those in low-risk patients:(13.98±1.29)and(16.97±1.15)s vs.(11.00±2.07)s,(18.87±4.68)and(22.69±2.96)mg/L vs.(15.45±5.54)mg/L,(27.43±5.05)and(31.02±4.56)ng/L vs.(21.39±8.54)ng/L,(

关 键 词：消化性溃疡出血 胃泌素类 C反应蛋白质 肿瘤坏死因子Α 

分 类 号：R573.1[医药卫生—消化系统]