血清PG、IL-8与老年NSAIDs相关性消化性溃疡出血的关系  

Relationship between serum PG,IL-8 and peptic ulcer bleeding associated with NSAIDs in the elderly

作　　者：张丹峰 杨姝洁[1] 笪晨星[1] 杜亭 白川琪 ZHANG Danfeng;YANG Shujie;DA Chenxing;DU Ting;BAI Chuanqi(Department of Gastroenterology,Shaanxi Provincial Corps Hospital of Chinese People’s Armed Police Force,Xi’an 710054,China)

机构地区：[1]武警陕西总队医院消化内科,西安710054

出　　处：《武警医学》2024年第12期1062-1066,共5页Medical Journal of the Chinese People's Armed Police Force

基　　金：陕西省中医管理局中医药科研课题(ZYMS016)

摘　　要：目的 探讨血清胃蛋白酶原(PG)、白细胞介素-8(IL-8)与老年非甾体类抗炎药(NSAIDs)相关性消化性溃疡出血的关系。方法 选取武警陕西总队医院2022-01至2023-12收治的老年NSAIDs相关性消化性溃疡患者110例,根据是否发生老年NSAIDs相关性消化性溃疡出血分为出血组(42例)和未出血组(68例)。收集两组患者一般资料并检测他们的血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、IL-8水平,计算PGR(PGⅠ与PGⅡ的比值),采用logistic回归模型分析发生消化性溃疡出血的危险因素,采用受试者工作特征(ROC)曲线分析血清PG、IL-8水平评估发生消化性溃疡出血的价值。结果 出血组与未出血组老年NSAIDs相关性消化性溃疡患者年龄、性别、吸烟史、饮酒史、BMI、高血压、糖尿病、高脂血症、消化道疾病史、冠心病、贫血、NSAIDs用药种类比较,差异无统计学意义(P>0.05),出血组患者消化性溃疡史、服用NSAIDs时间、PGⅡ水平、IL-8水平均高于未出血组,PGⅠ、PGR水平均低于未出血组(P<0.05);经多因素logistic回归模型分析,消化性溃疡史(OR=1.193,95%CI:1.120~1.271)、服用NSAIDs时间(OR=8.177,95%CI:1.970~33.936)、IL-8(OR=1.252,95%CI:1.065~1.474)均为老年NSAIDs相关性消化性溃疡患者发生消化性溃疡出血的独立危险因素,PGR(OR=0.002,95%CI:0.000~0.091)为保护因素(P<0.05);ROC曲线分析显示,PGR、IL-8单独预测消化性溃疡出血的受试者工作特征曲线下面积(AUC)(95%CI)分别为0.878(0.802~0.933)、0.832(0.749~0.896),采用log(P)联合预测AUC(95%CI)为0.947(0.888~0.981),联合预测效能比单独预测效能更好(P<0.05)。结论 血清PGR、IL-8水平与老年NSAIDs相关性消化性溃疡出血密切相关,可作为评估患者病情和预后的指标。Objective To investigate the relationship between serum pepsinogen(PG),interleukin-8(IL-8),and non-steroidal anti-inflammatory drugs(NSAIDs)related peptic ulcer bleeding in the elderly.Method A total of 110 elderly patients with NSAIDs related peptic ulcer admitted to Shaanxi Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2022 to December 2023 were selected,and divided into a bleeding group(42 cases)and a non-bleeding group(68 cases)according to whether NSAIDs-associated peptic ulcer occurred in elderly patients.The general data of two groups were collected and the serum levels of gastric protease I(PGⅠ),gastric proteaseⅡ(PGⅡ),and IL-8 were detected.The PGR(ratio of PG-ⅰto PG-ⅱ)was calculated.Logistic regression model was used to analyze the risk factors for peptic ulcer bleeding,and receiver operating characteristic(ROC)curve analysis was used to evaluate the value of serum PG and IL-8 levels for peptic ulcer bleeding.Results There was no significant difference in age,sex,smoking history,drinking history,BMI,hypertension,diabetes,hyperlipidemia,digestive tract disease history,coronary heart disease,anemia,or type of NSAIDs medication between the bleeding group and the non-bleeding group of elderly patients with NSAIDs related peptic ulcer(P>0.05).The history of peptic ulcer,time of taking NSAIDs,PGⅡand IL-8 levels in the bleeding group were higher than those in the non-bleeding group,and the levels of PGⅠand PGR were lower than those in the non-bleeding group(P<0.05);According to the analysis of multiple logistic regression models,history of peptic ulcer(OR=1.193,95%CI:1.120-1.271),time of taking NSAIDs(OR=8.177,95%CI:1.970-33.936),and IL-8(OR=1.252,95%CI:1.065-1.474)were all independent risk factors for peptic ulcer bleeding in elderly NSAIDs related peptic ulcer patients,and PGR(OR=0.002,95%CI:0.000-0.091)was the protective factor(P<0.05);ROC curve analysis showed that the area under the working characteristic curve(AUC)(95%CI)of PGR and IL-8 alone for predicting

关 键 词：胃蛋白酶原 白细胞介素-8 非甾体类抗炎药 消化性溃疡出血 

分 类 号：R573.1[医药卫生—消化系统] R971.1[医药卫生—内科学]