胃食管反流患者唾液SIgA、胃蛋白酶和呼出气一氧化氮水平与难治性咳嗽发生的相关性  

Correlation Between Salivary SIgA,Pepsin and Fractional Exhaled Nitric Oxide Levels and Refractory Cough in Patients with Gastroesophageal Reflux Disease

作　　者：蒋冬梅 李贵珍 史赞 寇学斌 JIANG Dongmei;LI Guizhen;SHI Zan;KOU Xuebin(Gastroenterology Department,Shangqiu Municipal Hospital,Shangqiu 476000,China)

机构地区：[1]商丘市立医院消化内科,河南商丘476000

出　　处：《河南医学研究》2024年第14期2561-2564,共4页Henan Medical Research

摘　　要：目的分析唾液分泌性免疫球蛋白A(SIgA)、胃蛋白酶和呼出气一氧化氮(FeNO)水平与胃食管反流病(GERD)患者发生难治性咳嗽的关系。方法选取2021年9月至2022年8月在商丘市立医院治疗的GERD患者,根据患者合并难治性咳嗽情况将患者分为GERD组与GERD合并难治性咳嗽组,收集患者DeMeester评分、反流周期数、最长反流时间资料,通过酶联免疫吸附法(ELISA)测定患者唾液SIgA、胃蛋白酶水平,通过NO分析仪分析患者FeNO水平,通过受试者工作特征(ROC)曲线分析患者唾液SIgA、胃蛋白酶和FeNO水平对GERD患者合并难治性咳嗽的诊断价值,通过logistic分析GERD合并难治性咳嗽的影响因素。结果与GERD组相比,GERD合并难治性咳嗽组患者DeMeester评分、最长反流时间、唾液胃蛋白酶、FeNO水平升高,唾液SIgA水平降低(P<0.05);唾液SIgA、胃蛋白酶和FeNO分别诊断GERD合并难治性咳嗽患者的ROC曲线下面积为0.660(敏感度为87.1%、特异度为42.9%)、0.792(敏感度为74.2%、特异度为83.7%)、0.898(敏感度为90.3%、特异度为87.8%),唾液SIgA是GERD患者合并难治性咳嗽的保护因素(OR=0.897,P<0.05),唾液胃蛋白酶和FeNO与GERD患者合并难治性咳嗽的危险因素(OR=1.072,1.297,P<0.05)。结论唾液SIgA水平降低,唾液胃蛋白酶、FeNO水平升高与GERD合并难治性咳嗽有关。Objective To analyze the relationship between salivary secretory immunoglobulin A(SIgA),pepsin and fractional exhaled nitric oxide(FeNO)levels and the occurrence of refractory cough in patients with gastroesophageal reflux disease(GERD).Methods GERD patients treated in Shangqiu Municipal Hospital from September 2021 to August 2022 were selected and divided into GERD group and GERD combined with refractory cough group based on their condition.Data on patients’DeMeester score,number of reflux cycles,and longest reflux time were collected.Salivary SIgA and gastric protein levels were measured by enzyme-linked immunosorbent assay(ELISA),and FeNO levels were analyzed by NO analyzer.The diagnostic value of salivary SIgA,pepsin and FeNO levels in GERD patients with refractory cough was analyzed by receiver operating characteristic(ROC)of subjects.The influencing factors of GERD complicated with refractory cough was analyzed through logistic analysis.Results Compared with GERD group,DeMeester score,longest reflux time,salivary pepsin and FeNO levels in GERD group with refractory cough increased,and salivary SIgA level decreased(P<0.05).Saliva SIgA,pepsin,and FeNO predicted the area under the curve of whether GERD patients had refractory cough or not,respectively 0.660(sensitivity 87.1%,specificity 42.9%),0.792(sensitivity 74.2%,specificity 83.7%),0.898(sensitivity 90.3%,specificity 87.8%).Salivary SIgA was a protective factor for GERD patients with refractory cough(OR=0.897,P<0.05),and salivary pepsin and FeNO were risk factors for GERD patients with refractory cough(OR=1.072,1.297,P<0.05).Conclusion The decrease of salivary SIgA level and the increase of salivary pepsin and FeNO levels were related to GERD complicated with refractory cough.

关 键 词：胃食管反流 难治性咳嗽 分泌性免疫球蛋白A 胃蛋白酶 呼出气一氧化氮 

分 类 号：R573[医药卫生—消化系统]