胃蛋白酶原水平与血液透析并发上消化道出血的关系研究

Relationship between pepsinogen level and hemodialysis with upper gastrointestinal hemorrhage

目的研究维持性血液透析(MHD)患者血清胃蛋白酶原I(PGI)、血清胃蛋白酶原II(PGII)水平及PGI/PGII比值(PGR)与上消化道出血的关系。方法选取中国人民解放军第901医院2017年1月至2018年1月收治的MHD并发上消化道出血的30例患者为观察组,同时随机选取门诊常规透析且无出血并发症的30例患者作为对照组,采用酶联免疫吸附试验检测两组患者PGI和PGII水平,计算PGR。比较两组患者PG I、PG II、PGR及其他指标的差异,分析上消化道出血的危险因素。结果观察组患者血清PGI、PGII水平高于对照组,差异有统计学意义(P<0.05)。观察组患者血红蛋白、红细胞水平低于对照组,尿素氮、肌酐水平高于对照组,差异有统计学意义(P<0.05)。logistic回归分析发现,血清高水平PGI、PGII是MHD并发上消化道出血的危险因素(P<0.05);ROC分析显示,ROC曲线下面积AUC分别为0.711、0.758。结论MHD并发上消化道出血患者血清PGI、PGII浓度较高,血清PG水平可能对MHD患者并发上消化道出血具有一定预测价值。

Objective To study the relationship between serum pepsinogen I (PG I), serum pepsinogen II (PG II) and PG I/PG II ratio (PGR) in the maintenance hemodialysis (MHD) patients with upper gastrointestinal hemorrhage. Methods Thirty MHD patients with upper gastrointestinal hemorrhage,whowere admitted to the 901th Hospital of Chinese People’s Liberation Army from January 2017 to January 2018, were selected as the observation group. Thirty routine dialysis patients with no hemorrhage complications were selected randomly as the control group. The serum PG I and PG II levels in two groups were measured by enzyme-linked immunosorbent assay, and PGR was calculated. The differences in PG I, PG II, PGR and other indicators between the two groups were compared and the risk factors for upper gastrointestinal hemorrhage were analyzed. Results The serum PG I and PG II levels in observation group were higher than those in control group, and the difference was statistically significant (P<0.05). The levels of hemoglobin and red blood cell in observation group were lower than those in control group. The levels of urea nitrogen and creatinine were higher than those in control group with no statistically significant difference in PGR ( P <0.05). Logistic regression analysis showed that high serum PG I and PG II levels were the risk factors for MHD with upper gastrointestinal hemorrhage ( P <0.05). ROC analysis showed that the area under the ROC curve was 0.711 and 0.758, respectively. Conclusion The serum PG I and PG II concentrations are higher in MHD patients with upper gastrointestinal hemorrhage. Serum PG levels may have predictive value for MHD patients with upper gastrointestinal hemorrhage.