胃蛋白酶原测定检查在儿童消化性溃疡中诊断价值  

Diagnostic value of pepsinogen determination in children peptic ulcer

作　　者：王一 张俐 吴楠 陈桂英 WANG Yi;ZHANG Li;WU Nan;CHEN Guiying(Department of Gastroenterology,Beijing Children’s Hospital Heilongjiang Hospital/Jiangnan Hospital,Sixth Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150010,China;Department of Child Healthcare,Beijing Children’s Hospital Heilongjiang Hospital/Jiangnan Hospital,Sixth Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150010,China;Department of Emergency,Beijing Children’s Hospital Heilongjiang Hospital/Jiangnan Hospital,Sixth Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150010,China)

机构地区：[1]北京儿童医院黑龙江医院/哈尔滨医科大学附属第六医院江南院区消化内科,哈尔滨150010 [2]北京儿童医院黑龙江医院/哈尔滨医科大学附属第六医院江南院区儿童保健科,哈尔滨150010 [3]北京儿童医院黑龙江医院/哈尔滨医科大学附属第六医院江南院区急诊科,哈尔滨150010

出　　处：《重庆医学》2024年第19期2949-2953,2959,共6页Chongqing Medical Journal

基　　金：黑龙江省卫生健康委员会科研课题(20220606011013)。

摘　　要：目的探讨胃蛋白酶原(PG)诊断儿童消化性溃疡的价值。方法选取2019年7月至2024年1月因恶心、呕吐、腹痛、消化道出血等消化道症状于该院完成胃镜检查的855例患儿为研究对象,根据胃镜检查结果分为健康体检组(n=223)、慢性胃炎组(n=418)、慢性胃炎合并十二指肠球炎组(n=168)及胃溃疡及十二指肠球部溃疡组(消化性溃疡组,n=46)。共503例研究对象完善13 C呼气试验并根据结果分为幽门螺杆菌(Hp)阳性和Hp阴性,采取乳胶免疫比浊法检测所有研究对象血清PGⅠ、PGⅡ、PGⅠ/PGⅡ水平,分析该项指标在不同年龄、不同胃部疾病中的差异,以及在消化性溃疡中的诊断价值。结果消化性溃疡组女性患儿占比明显低于其他3组,差异有统计学意义(P<0.05)。慢性胃炎组<7岁患儿PGⅠ水平低于>12岁,差异有统计学意义(P<0.05)。慢性胃炎合并十二指肠球炎组<7岁患儿PGⅠ水平低于>12岁组,<7岁、7~12岁患儿PGⅡ水平低于>12岁组,差异有统计学意义(P<0.05)。与健康体检组比较,慢性胃炎组PGⅠ水平升高,慢性胃炎合并十二指肠球炎组PGⅠ、PGⅡ升高,PGⅠ/PGⅡ降低,消化性溃疡组PGⅠ、PGⅡ升高,PGⅠ/PGⅡ降低,差异有统计学意义(P<0.05)。与慢性胃炎组比较,慢性胃炎合并十二指肠球炎组PGⅠ/PGⅡ降低,消化性溃疡组PGⅠ、PGⅡ升高,PGⅠ/PGⅡ降低,差异有统计学意义(P<0.05)。与慢性胃炎合并十二指肠球炎组比较,消化性溃疡组PGⅠ、PGⅡ升高,PGⅠ/PGⅡ降低,差异有统计学意义(P<0.05)。PGⅠ和PGⅡ预测消化性溃疡的AUC分别为0.689、0.785。以Youden指数最大时作为截断值,当PGⅠ为69.25μg/L时,其Youden指数达到最大值,消化性溃疡诊断灵敏度为67.4%,特异度为72.3%;当PGⅡ为12.25μg/L时,其Youden指数达到最大值,消化性溃疡诊断灵敏度为71.7%,特异度为76.1%。与Hp阴性比较,慢性胃炎组和慢性胃炎合并十二指肠球炎组Hp阳性PGⅠ和PGⅡ升高,Objective To investigate the value of pepsinogen(PG)in diagnosing children peptic ulcer.Methods A total of 855 children patients completing gastroscopic examination in this hospital due to nausea,vomiting,abdominal pain,gastrointestinal bleeding and other gastrointestinal symptoms from July 2019 to January 2024 were selected as the study subjects.According to the gastroscopic examination results,they were divided into the healthy physical examination group(n=223),chronic gastritis group(n=418),chronic gastritis combined with duodenal bulbar inflammation(n=168)and gastric ulcer and duodenal bulbous ulcer group(peptic ulcer group,n=46).A total of 503 study subjects perfected the 13C breath test and divided into Helicobacter pylori(Hp)positive and Hp negative according to the test results.Serum PGⅠ,PGⅡand PGⅠ/PGⅡlevels in all study subjects were measured by latex immunoturbidimetry.The differences of this indicator among different ages and different gastric diseases and its diagnostic value in peptic ulcer were analyzed.Results The proportion of female children patients in the peptic ulcer group was significantly lower than that in the other 3 group,and the difference was statistically significant(P<0.05).The PGⅠlevel of children patients<7 years old in the chronic gastritis group was lower than that of the children patients>12 years old group,and the difference was statistically significant(P<0.05).The PG level of the children patients<7 years old in chronic gastritis combined with duodenal bulbar inflammation group was lower than that in the children patients>12 years old group,the PGⅡlevel in the children patients<7 years old,7-12 years was lower than that in the children patients>12 year old,and the difference was statistically significant(P<0.05).Compared with the healthy physical examination group,the PGⅠlevel in the chronic gastritis group was increased,the PGⅠand PGⅡlevels in the chronic gastritis combined with duodenal bulbar inflammation group were increased,the PGⅠ/PGⅡratio was decre

关 键 词：胃功能测定 胃蛋白酶原 血清学检查 儿童 消化性溃疡 幽门螺杆菌 

分 类 号：R725.7[医药卫生—儿科]