血清胃泌素-17、胃蛋白酶原及PGR在慢性萎缩性胃炎诊断中应用价值  

Application value of serum gastrin-17,pepsinogen and PGR in clinical screening and determination of chronic atrophic gastritis

作　　者：张弛 廖苏丹 苏钢 ZAHNG Chi;LIAO Su-dan;SU Gang(Department of General Medicine,The First People's Hospital of Wuhu,Wuhu Anhui 241000,China)

机构地区：[1]芜湖市第一人民医院全科医学科,安徽芜湖241000

出　　处：《临床和实验医学杂志》2024年第16期1704-1707,共4页Journal of Clinical and Experimental Medicine

基　　金：2020年度安徽省自然科学基金项目(编号:2008085MH213)。

摘　　要：目的探讨血清胃泌素-17(G-17)、胃蛋白酶原(PG)及PGⅠ/PGⅡ(PGR)在慢性萎缩性胃炎(CAG)诊断中的应用价值。方法回顾性选取2020年1月至2023年6月入芜湖市第一人民医院的80例CAG患者,将其设为观察组;同时,选取同一时期入院进行体检的80名健康者为对照组。采用荧光免疫双抗体夹心法定量测定两组研究对象的血清G-17、PGⅠ、PGⅡ及PGR水平,并进行两组对比;同时比较不同萎缩部位(胃体萎缩、全胃多灶萎缩、胃窦萎缩)的G-17、PGⅠ、PGⅡ及PGR水平。采用受试者操作特征(ROC)曲线分析G-17、PGⅠ、PGR单一与联合检测对CAG的诊断价值。结果观察组患者的血清G-17、PGⅠ、PGR水平分别为(5.01±3.22)pmol/L、(53.28±18.24)μg/L、4.09±3.76,均明显低于对照组[(9.18±2.89)pmol/L、(88.47±20.72)μg/L、8.58±4.81],差异均有统计学意义(P<0.05);两组患者的血清PGⅡ水平比较,差异无统计学意义(P>0.05)。胃体萎缩患者G-17水平为(17.46±2.46)pmol/L,高于全胃多灶萎缩患者[(15.44±2.48)pmol/L]、胃窦萎缩患者[(7.52±2.46)pmol/L],PGⅠ、PGⅡ及PGR水平分别为(34.28±3.49)μg/L、(4.16±1.14)μg/L、10.7±1.5,均低于全胃多灶萎缩患者[(44.12±4.91)μg/L、(8.47±1.55)μg/L、10.4±1.9]、胃窦萎缩患者[(89.58±14.23)μg/L、(7.45±1.56)μg/L、12.6±1.6],差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,CAG诊断中G-17的临界值、ROC曲线下面积(AUC)、敏感度、特异度依次为10.32 pmol/L、0.879、60.87%、70.09%,PGⅠ依次为106.09μg/L、0.891、63.09%、75.57%,PGR依次为12.35、0.869、75.49%、75.18%,G-17、PGⅠ、PGR联合诊断的AUC、敏感度、特异度依次为0.902、82.18%、68.09%。结论CAG诊断中G-17与PG具有一定应用价值,G-17、PGⅠ水平过低提示CAG发生风险较高,且G-17、PGⅠ、PGR可用于辅助判断CAG患者的不同萎缩部位,G-17、PGⅠ、PGR联合检测不仅可进一步提升CAG诊断精准性,还可为CAG诊疗提供参考。Objective To explore the application value of serum gastrin-17(G-17),pepsinogen(PG)and PGⅠ/PGⅡvatio(PGR)in the diagnosis of chronic atrophic gastritis(CAG).Methods Eighty patients with CAG admitted to The First People's Hospital of Wuhu from January 2020 to June 2023 were selected as the observation group;meanwhile,80 healthy patients admitted for physical examination during the same period were selected as the control group.The serum levels of G-17,PGI,PGⅡand PGR of both groups were measured and compared by sandwich method,and the levels of G-17,PGⅠ,PGⅡand PGR in different atrophic sites(gastric body atrophy,whole gastric multifocal atrophy and gastric antrum atrophy)were compared.The diagnostic values of G-17,the PGI and PGR on CAG were analyzed using receiver operating characteristic(ROC)curve.Results The serum levels of G-17,PGⅠand PGR in the observation group were(5.01±3.22)pmol/L,(53.28±18.24)μg/L and 4.09±3.76,respectively,which were significantly lower than those in the control group[(9.18±2.89)pmol/L,(88.47±20.72)μg/L,8.58±4.81],the differences were statistically significant(P<0.05);there was no statistically significant difference in serum PGⅡlevel between the two groups(P>0.05).The level of G-17 in patients with gastric body atrophy was(17.46±2.46)pmol/L,which was higher than that in patients with whole gastric multifocal atrophy[(15.44±2.48)pmol/L]and gastric antrum atrophy[(7.52±2.46)pmol/L],the levels of PGⅠ,PGⅡand PGR were(34.28±3.49)μg/L,(4.16±1.14)μg/L and 10.7±1.5,respectively,which were lower than those in patients which whole gastric multifocal atrophy[(44.12±4.91)μg/L,(8.47±1.55)μg/L,10.4±1.9],patients with gastric antrum atrophy[(89.58±14.23)μg/L,(7.45±1.56)μg/L,12.6±1.6],the differences were statistically significant(P<0.05).The ROC curve analysis results showed that,the cut-off value,G-17,area under the curve(AUC),sensitivity and specificity in CAG diagnosis were 10.32 pmol/L,0.879,60.87%,70.09%,PGI of 106.09μg/L,0.891,63.09%and 75.57%,PGR were

关 键 词：胃炎 萎缩性 胃泌素类 胃蛋白酶原类 PGⅠ/PGⅡ 诊断价值 

分 类 号：R573.32[医药卫生—消化系统]