血清胃泌素水平与肝硬化合并胃溃疡患者疼痛程度的相关性

Correlation between serum gastrin level and pain degree in patients with liver cirrhosis and gastric ulcer

目的探讨血清胃泌素水平与肝硬化合并胃溃疡患者疼痛程度的相关性。方法回顾性选取2016年1月至2020年12月西安市中医医院收治的80例肝硬化合并胃溃疡的患者,作为观察组,另选取同期收治的80例单纯肝硬化患者,作为对照组。对比两组患者的疼痛视觉模拟评分法(VAS)评分。观察组依照日均VAS评分对患者的疼痛程度进行评价,根据VAS评分结果分组,0~3分为轻度疼痛组(n=38),4~7分为中度疼痛组(n=31),8~10分为重度疼痛组(n=11)。比较3组患者的血清降钙素原、高敏C反应蛋白(hs-CRP)、胃泌素水平与临床一般情况。分析血清胃泌素、hs-CRP和胃溃疡分期胃泌素水平与肝硬化合并胃溃疡患者疼痛程度的相关性。结果观察组患者VAS评分为(5.95±0.14)分,明显高于对照组[(2.13±0.25)分],差异有统计学意义(P<0.05)。3组不同疼痛程度患者降钙素原水平比较,差异无统计学意义(P>0.05);重度疼痛组患者胃泌素和hs-CRP水平均高于中度疼痛组、轻度疼痛组[(115.23±20.11)ng/L vs.(95.46±13.34)ng/L vs.(67.54±8.30)ng/L、(9.24±4.34)mg/L vs.(8.85±3.25)mg/L vs.(6.57±3.36)mg/L],差异均有统计学意义(P<0.05)。不同疼痛程度的肝硬化合并胃溃疡患者性别、年龄、饮酒史、肝硬化类型对比差异无统计学意义(P>0.05),3组患者胃溃疡分期情况比较,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,hs-CRP水平与肝硬化合并胃溃疡患者的疼痛程度无明显相关性(r=0.245,P>0.05),胃泌素和胃溃疡分期与肝硬化合并胃溃疡患者的疼痛程度呈正相关(r=0.586、0.484,P<0.05)。结论肝硬化合并胃溃疡患者疼痛程度比单纯肝硬化患者剧烈,而且患者疼痛与血清胃泌素水平和胃溃疡分期有着明显关系。

Objective To investigate the correlation between serum gastrin level and pain degree in patients with liver cirrhosis and gastric ulcer.Methods A total of 80 patients with liver cirrhosis and gastric ulcer who were treated in Xi'an Hospital of Traditional Chinese Medicine from January 2016 to December 2020 were retrospectively selected,and divided into the observation group.Another 80 patients with simple liver cirrhosis in the same period were selected and divided into the control group.The pain situation of the two groups was compared.According to the daily VAS score,they were divided into groups according to different pain levels,0-3 points were divided into mild pain group(n=38),4-7 points were divided into moderate pain group(n=31),8-10 points were divided into severe group(n=11).The serum procalcitonin,high-sensitivity C-reactive protein(hs-CRP)and gastrin levels of the three groups of patients were compared with the general clinical conditions.Finally,the correlation between serum gastrin,hs-CRP and gastric ulcer stage gastrin levels and pain in patients with liver cirrhosis and gastric ulcer was analyzed.Results The VAS score of the observation group was(5.95±0.14)points,which was significantly higher than that of the control group[(2.13±0.25)]points,and the difference was statistically significant(P<0.05).There was no significant difference in the levels of procalcitonin among the three groups of patients with different pain degrees(P>0.05);The levels of gastrin and hs-CRP in the severe pain group were higher than those in the moderate pain group and the mild pain group[(115.23±20.11)ng/L vs.(95.46±13.34)ng/L vs.(67.54±8.30)ng/L,(9.24±4.34)mg/L vs.(8.85±3.25)mg/L vs.(6.57±3.36)mg/L],the differences were statistically significant(P<0.05).There was no significant difference in gender,age,alcohol drinking history and cirrhosis type among three groups of patients with different degree of pain(P>0.05),the gastric ulcer stages of the three groups were compared,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that hs-CRP level had no significant correlation with the degree of pain in patients with liver cirrhosis and gastric ulcer(r=0.245,P>0.05),gastrin and gastric ulcer stage were positively correlated with the degree of pain in patients with liver cirrhosis and gastric ulcer(r=0.586,0.484;P<0.05).Conclusion The degree of pain in patients with liver cirrhosis complicated with gastric ulcer is more severe than that in patients with simple liver cirrhosis,and there is a significant relationship between the pain and serum gastrin level and gastric ulcer stage.