血清MCP-1及PGE_(2)水平对消化性溃疡并发上消化道出血风险的预测价值  

Predictive value of serum MCP-1 and PGE_(2)levels for the risk of peptic ulcer complicated with upper gastrointestinal bleeding

作　　者：宋衍超 任成果 唐燕 林森 SONG Yanchao;REN Chengguo;TANG Yan;LIN Sen(Department of Critical Care Medicine,Santai Hospital Affiliated to North Sichuan Medical College,Mianyang Sichuan 612200,China)

机构地区：[1]川北医学院附属三台医院重症医学科,四川绵阳612200

出　　处：《中国急救复苏与灾害医学杂志》2024年第10期1327-1330,1335,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨消化性溃疡(PU)并发上消化道出血(UGIB)的危险因素,并分析血清单核细胞趋化因子1(MCP-1)及前列腺素E_(2)(PGE_(2))水平变化对PU并发UGIB风险的预测价值。方法回顾性选取2020年8月—2022年7月诊治的128例PU患者的临床资料,根据PU患者治疗结束3个月后是否发生UGIB分为UGIB组和非UGIB组,收集两组患者的基线资料及血清MCP-1、PGE_(2)水平变化;采用Logistic回归模型分析PU并发UGIB的危险因素;采用受试者工作特征(ROC)曲线模型分析MCP-1、PGE_(2)水平变化对PU患者发生UGIB的预测效能。结果共42例患者并发UGIB,纳入UGIB组;86例患者未发生UGIB,纳入非UGIB组。两组的吸烟史占比、溃疡位置、溃疡直径、MCP-1水平、PGE_(2)水平差异有统计学意义(P<0.05);多因素Logistic回归模型显示,溃疡位置、溃疡直径、MCP-1水平、PGE_(2)水平是影响PU患者并发UGIB的危险因素(P<0.05);ROC曲线分析显示,MCP-1、PGE_(2)水平及两项联合预测PU患者并发UGIB的曲线下面积(AUC)分别为0.798、0.784、0.934(P<0.05)。结论血清MCP-1、PGE_(2)对PU并发UGIB患者具有一定预测价值,尤其两项指标联合检测预测效能更高。Objective To explore the risk factors of peptic ulcer(PU)complicated with upper gastrointestinal bleeding(UGIB),and to analyze the predictive value of changes in serum monocyte chemoattractant-1(MCP-1)and prostaglandin E_(2)(PGE_(2))levels on the risk of PU complicated with UGIB.Methods Retrospective selected clinical data of 128 PU patients diagnosed and treated from August 2020 to July 2022.PU patients were divided into UGIB group and non UGIB group based on whether UGIB occurred 3 months after treatment.Baseline data of the two groups of patients were collected,and the changes in serum MCP-1 and PGE_(2)levels during treatment were compared;Using Logistic regression model to analyze the risk factors of PU complicated with UGIB;Using ROC curve model to analyze the predictive efficacy of changes in MCP-1 and PGE_(2)levels on the occurrence of UGIB in PU patients.Results 42 patients with UGIB were included in the UGIB group.86 patients did not develop UGIB and were included in the non UGIB group.There was a statistically significant difference in the proportion of smoking history,proportion of duodenal ulcers,ulcer diameter,MCP-1 level,and PGE_(2)level between the two groups(P<0.05);The multivariate Logistic regression model showed that duodenal ulcer,increased ulcer diameter,MCP-1 level,and PGE_(2)level were risk factors for the development of UGIB in PU patients(P<0.05);ROC curve analysis showed that the levels of MCP-1 and PGE_(2),as well as the AUC values of the two combined predictions for UGIB in PU patients were 0.798,0.784,0.934(P<0.05).Conclusion Serum MCP-1 and PGE_(2)have certain predictive value for patients with PU complicated with UGIB,especially the combined detection of the two indicators has higher predictive efficacy.

关 键 词：单核细胞趋化因子1 前列腺素E_(2) 消化性溃疡 上消化道出血 风险预测 

分 类 号：R573.1[医药卫生—消化系统] R573.2[医药卫生—内科学]