联合检测血清胃蛋白酶原、胃泌素⁃17、HP抗体在部队官兵慢性萎缩性胃炎诊断中的价值  

Value of combined detection by serum pepsinogen,gastrin⁃17 and HP antibodies in the diagnosis of atrophic gastritis in military personnel

作　　者：董文珠 梁越 陈燕 苑刚 董东方 王群英 于海涛 Dong Wenzhu;Liang Yue;Chen Yan;Yuan Gang;Dong Dongfang;Wang Qunying;Yu Haitao(Department of Gastroenterology,No.971 Naval Hospital,Qingdao 266071,China)

机构地区：[1]海军第九七一医院消化科,山东青岛266071 [2]海军军医大学第一附属医院消化科

出　　处：《海军医学杂志》2023年第3期217-221,共5页Journal of Navy Medicine

基　　金：青岛市市南区科技计划项目(2020-2-009-YY);青岛市医药科研指导计划(2020-WJZD199)。

摘　　要：目的通过测定不同胃疾病患者的血清胃蛋白酶原(PGⅠ、PGⅡ)、两者比值(PGR)以及胃泌素⁃17(G⁃17)、幽门螺杆菌(HP)抗体水平,探讨联合检测PG、G⁃17、HP抗体诊断部队官兵慢性萎缩性胃炎的价值。方法选取2020年7月至2021年7月行胃镜检查的门诊及住院部队官兵共236例,均有消化不良症状,年龄22~81岁[(56.70±10.15)岁]。每名患者均抽血进行了PGⅠ、PGⅡ、G⁃17和HP抗体检测。结果共236名患者纳入研究,非萎缩性胃炎组133例,萎缩性胃炎组103例。萎缩性胃炎组PGⅠ、PGR的水平低于非萎缩性胃炎组,G⁃17水平高于非萎缩性胃炎组。HP阳性组PGR水平低于HP阴性组,PGⅡ、G⁃17水平高于HP阴性组。PGⅠ、PGR、G⁃17诊断慢性萎缩性胃炎的最佳临界值分别为68.84μg/L、6.33、4.73 pmol/L,灵敏度分别为0.72、0.91、0.78,特异度分别为0.59、0.57、0.55。受试者操作特征(ROC)曲线的曲线下面积(AUC)分别为0.68、0.79、0.65。而联合检测法诊断慢性萎缩性胃炎的最佳临界值为9.50分,灵敏度为0.80,特异度为0.77,ROC曲线的曲线下面积为0.83。结论联合检测PG和G⁃17及HP抗体对评估部队官兵慢性萎缩性胃炎具有一定的诊断价值。Objective To investigate the value of combined detection by serum pepsinogen,gastrin⁃17 and HP antibodies in the diagnosis of atrophic gastritis in military personnel through the access of detecting PGⅠand PGⅡlevels,the ratio of the two(PGR)and HP infection in the patients with different gastric diseases.Methods A total of 236 military outpatients and inpatients with dyspeptic symptoms and an age of 22 to 81(56.70±10.15)years,who underwent gastroscopy from July 2020 to July 2021 were enrolled as study subjects.Blood samples were taken for the detection of PGⅠ,PGⅡ,G⁃17 and HP.Results Included in the study group were 236 patients,of whom 133 had non⁃atrophic gastritis(designated as the non⁃atrophic gastritis group)and 103 had atrophic gastritis group(designated as the atrophic gastritis group).The levels of PGⅠand PGR in the atrophic gastritis group were lower than those in the non⁃atrophic gastritis group,while G⁃17 level in the former was higher than that in the latter.The level of PGR in the HP positive group was lower than that in the HP negative group,while the levels of PGⅡand G⁃17 were higher than those in the HP negative group.The optimal critical values of PGⅠ,PGR and G⁃17 for the diagnosis of chronic atrophic gastritis were respectively 68.84μg/L,6.33 and 4.73 pmol/L.Corresponding sensitivity was respectively 0.72,0.91 and 0.78,and specificituy was respectively 0.59,0.57 and 0.55.AUCs of the receiver operating characteristic(ROC)curve analysis were respectively 0.68,0.79 and 0.65.However,the optimal critical value of the combined detection method for the diagnosis of chronic atrophic gastritis were 9.5,sensitivity was 0.80 and specificity was 0.77,and the AUC was 0.83.Conclusion Combined detection of PG,G⁃17 and HP antibodies is a reliable method to evaluate the incidence of atrophic gastritis among military personnel.

关 键 词：胃蛋白酶原 胃泌素 萎缩性胃炎 HP抗体 

分 类 号：R573.3[医药卫生—消化系统]