血清胃功能检测用于NSAIDs相关胃病出血预警的临床评价

Clinical evaluation of serum gastric function detection for warning of NSAIDS-related gastric hemorrhage

目的探讨非甾体抗炎药(NSAIDs)相关胃病出血患者血清胃功能指标对胃病出血的预测价值。方法选取2020年5月至2022年5月江西省景德镇市第二人民医院接受NSAIDs(阿司匹林)治疗的慢性疾病患者191例为研究对象。根据治疗3个月期间是否发生胃病出血分为出血组、未出血组。比较两组治疗前后血清胃功能指标水平。分析胃病出血发生影响因素、血清胃功能指标对胃病出血的预测效果。结果NSAIDs治疗3个月内胃病出血发生率为9.95%;两组年龄、酗酒史、消化道病史、使用胃黏膜保护剂比较,差异有统计学意义(P<0.05)。两组血清胃泌素-17(G-17)、胃蛋白酶原(PG)Ⅰ、PGⅡ、PGⅠ/PGⅡ组间、时间及交互作用比较,差异有统计学意义(P<0.05)。其中出血组治疗2个月后,G-17低于治疗前及治疗1个月后,且低于未出血组;PGⅠ、PGⅡ、PGⅠ/PGⅡ高于治疗前及治疗1个月后,且高于未出血组,差异有统计学意义(P<0.05)。经logistic多因素回归分析显示,年龄,酗酒史,消化道病史,胃黏膜保护剂,治疗2个月后血清G-7,PG-Ⅰ、PGⅡ、PGⅠ/PGⅡ水平均为胃病出血发生的影响因素(P<0.05)。治疗2个月后血清G-17、PGⅠ、PGⅡ、PGⅠ/PGⅡ联合预测胃病出血的AUC为0.879,大于单项指标预测,差异有统计学意义(P<0.05)。结论NSAIDs相关胃病出血患者血清胃功能指标差异性表达,联合检测血清胃功能指标对胃病出血具有一定预测价值。

Objective To investigate the predictive value of serum gastric function indexes in patients with non-steroidal anti-inflammatory drugs(NSAIDs)related gastric hemorrhage.Methods A total of 191 patients with chronic diseases who received NSAIDs(Aspirin)in the Second People’s Hospital of Jingdezhen City,Jiangxi Province from May 2020 to May 2022 were selected as the study objects.According to the occurrence of gastric hemorrhage during three months of treatment,they were divided into bleeding group and no bleeding group.The levels of serum gastric function indexes before and after treatment were compared between the two groups.The influencing factors of gastric hemorrhage and the prediction effect of serum gastric function index on gastric hemorrhage were analyzed.Results The incidence of gastric hemorrhage within three months after NSAIDs treatment was 9.95%.There were statistically significant differences in age,history of alcoholism,history of digestive tract and,use of gastric mucosal protective agents between the two groups(P<0.05).There were statistically significant differences in serum gastrin-17(G-17),pepsinogen(PG)Ⅰ,PGⅡ,and PGⅠ/PGⅡbetween the two groups(P<0.05).After two months of treatment,the G-17 level in the bleeding group was lower than that before and after one month of treatment,and lower than that in the non-bleeding group.The levels of PGⅠ,PGⅡ,and PGⅠ/PGⅡwere higher than those before treatment and after one month of treatment,and higher than those in non-bleeding group,the differences were statistically significant(P<0.05).Logistic regression analysis showed that age,history of alcoholism,history of digestive tract,gastric mucosal protective agents,serum G-7,PG-Ⅰ,PG-Ⅱ,and PG-Ⅰ/PG-Ⅱlevels after two months of treatment were all influential factors in the occurrence of gastric hemorrhage(P<0.05).After two months of treatment,the AUC of serum G-17,PG-Ⅰ,PG-Ⅱ,and PG-Ⅰ/PG-Ⅱcombined predicted gastric hemorrhage was 0.879,which was higher than that predicted by any single index,and the differences were statistically significant(P<0.05).Conclusion The different expression of serum gastric function index in patients with NSAIDs related gastric hemorrhage,combined detection of serum gastric function index has a certain predictive value for gastric hemorrhage.