血清胃蛋白酶Ⅰ、Ⅱ和胃泌素17在腹泻患者中的表达及其意义

Expression and Significance of Serum Pepsin Ⅰ,Ⅱ and Gastrin 17 in Patients with Diarrhea

目的观察腹泻患者血清胃蛋白酶原(PGⅠ、PGⅡ、PGⅠ/Ⅱ)及胃泌素17(G-17)水平变化,并探讨其临床意义。方法选择2019年8月~2020年2月在西安医学院第一附属医院消化内科门诊及住院部行胃功能检测的腹泻患者140例,根据病情分为急性腹泻组57例和慢性腹泻组83例,另外选择182例健康对照者作为对照组,比较三组血清PGⅠ、PGⅡ、和G-17水平,并计算PGⅠ/Ⅱ比值(PGR),分析其临床意义。结果急性腹泻组、慢性腹泻组血清PGⅠ、PGⅡ、和G-17水平均高于对照组,且急性腹泻组高于慢性腹泻组,差异有统计学意义(P<0.05);急性腹泻组男性PGⅠ、PGⅡ水平高于慢性腹泻组,G-17水平高于对照组,差异有统计学意义(P<0.05);急性、慢性腹泻组女性G-17高于对照组,且急性腹泻组女性高于慢性腹泻组,差异有统计学意义(P<0.05);三组PGR水平比较,差异无统计学意义(P>0.05)。ROC曲线显示,PGⅠ、PGⅡ、和G-17诊断急性腹泻的AUC分别为0.693、0.712、0.757,诊断慢性腹泻的AUC分别为0.602、0.606、0.607。结论血清胃蛋白酶原及胃泌素17与胃黏膜炎性病变相关,可作为一种急慢性腹泻患者动态疗效评估、诊断,以及判断疾病是否复发的辅助手段。

Objective To observe the changes of serum pepsinogen(PG I,PG II,PG I/PG II)and gastrin 17(G-17)levels in patients with diarrhea,and to explore their clinical significance.Methods From August 2019 to February 2020,140 patients with diarrhea who underwent gastric function testing in the outpatient and inpatient department of the Department of Gastroenterology of the First Affiliated Hospital of Xi'an Medical University were selected.According to the condition,they were divided into 57 cases in acute diarrhea group and 83 cases in chronic diarrhea group.In addition,182 healthy controls were selected as the control group to compare the serum PGⅠ,PGⅡ,and G-17 levels of the three groups,and calculate the PGⅠ/Ⅱratio(PGR)to analyze its clinical significance.Results The levels of serum PGⅠ,PGⅡ,and G-17 in the acute diarrhea group and the chronic diarrhea group were higher than those in the control group,and the acute diarrhea group was higher than that in the chronic diarrhea group,the difference was statistically significant(P<0.05);The levels of PGⅠand PGⅡin men in the acute diarrhea group were higher than those in the chronic diarrhea group,and the G-17 levels were higher than those in the control group,the difference was statistically significant(P<0.05);The G-17 of women in the acute and chronic diarrhea groups was higher than that in the control group,and the women in the acute diarrhea group were higher than those in the chronic diarrhea group,the difference was statistically significant(P<0.05);the PGR levels of the three groups were not statistically significant(P>0.05).The ROC curve showed that the AUCs of PGⅠ,PGⅡ,and G-17 for the diagnosis of acute diarrhea were 0.693,0.712,0.757,and the AUCs for the diagnosis of chronic diarrhea were 0.602,0.606,and 0.607,respectively.Conclusion Serum pepsinogen and gastrin 17 are related to gastric mucosal inflammatory lesions,and can be used as a dynamic therapeutic evaluation and diagnosis of patients with acute and chronic diarrhea,as well as auxiliary means to determine whether the disease has recurred.