血清胃蛋白酶原水平在胃食管反流病诊断中的应用价值

The Application Value of the Serum Pepsinogen Level in the Diagnosis of Gastroesophageal Reflux Disease

目的研究血清胃蛋白酶原(pepsinogen,PG)水平在胃食管反流病诊断中的价值,并对三种检测试剂盒进行相关性分析。方法选取2018年8月至2019年2月在火箭军特色医学中心收治的胃食管反流病患者40例,同期健康体检者40例,比较2组血清PGI、PGII及PGI/PGII水平,建立ROC曲线并分析PGI、PGII及PGI/PGII对胃食管反流病诊断的价值。结果胃食管反流病组血清中PGI及PGI/PGII均高于对照组,差异有统计学意义(P<0.05),两组血清中PGII水平无显著差异(P>0.05)。ROC曲线分析显示,PGI对胃食管反流病具有诊断价值(曲线下面积0.739),PGII与PGI/PGII诊断价值不大(曲线下面积0.614、0.696)。国产某A产品与雅培检测系统对PGI、PGII及PGI/PGII检测的相关性分别为0.9947、0.9893、0.8063,国产某B产品与雅培检测系统对PGI检测的相关性为0.9427,但PGII与PGI/PGII两者与雅培检测系统相关性为0.7957、0.7695。结论血清胃蛋白酶原水平对胃食管反流病有较好的诊断意义,可作为胃食管反流病实验室诊断的一项新指标。

Objective To evluate the value of serum pepsinogen(PG)level in the diagnosis of gastroesophageal reflux disease,and to analyze the correlations of three test kits.Methods We selected 40 patients with gastroesophageal reflux disease who enrolled in the Rocket Military Medical Center from August,2018 to February,2019 for this study.During the same time period,40 healthy subjects were selected as the healthy controls.The serum PGI and PGII were compared between the two groups.PGI/PGII levels were used to establish receiver operating characteristic curves and calculate the area under the line to analyze the value of PGI,PGII and PGI/PGII in the diagnosis of gastroesophageal reflux disease.Results The serum levels of PGI and PGI/PGII in the gastroesophageal reflux disease group were significantly higher than those in the control group( P <0.05).There was no significant difference in serum PGII between the two groups( P >0.05).ROC curve analysis showed that PGI had a decent diagnostic value for gastroesophageal reflux disease(area under the curve of 0.739),and the performances of PGII and PGI/PGII were not significant(area under the curve were 0.614 and 0.696).For PGI,PGII and PGI/PGII detection,the correlation between domestic A product and Abbott detection system were 0.9947,0.9893 and 0.8063,respectively,while for PGI detection,the correlation between domestic B product and Abbott detection system was 0.9427,and for PGII and PGI/PGII detection,the correlation between domestic B product and Abbott detection system were 0.7957 and 0.7695,respectively.Conclusion Serum pepsinogen level has a promising diagnostic value for gastroesophageal reflux disease and can be used as a novel indicator for laboratory diagnosis of gastroesophageal reflux disease.