NOS、COX-2在不同类型胃食管返流病中的表达水平与意义

Expression Levels and Significance of NOS and COX-2 in Different Types of Gastroesophageal Reflux Disease

目的:探讨一氧化氮合酶(NOS)、环氧合酶-2(COX-2)在不同类型胃食管返流病中的表达水平与意义。方法:回顾性分析2017年1月-2020年1月鞍钢集团公司总医院收治的200例胃食管返流病患者的临床资料。根据患者的诊断结果,将全部胃食管返流病患者分为三组,非糜烂性胃食管返流病为A组(n=73),返流性食管炎为B组(n=68),Barrett食管为C组(n=59)。选择同时间段内在医院进行健康体检的患者80例作为对照组。比较四组患者的NOS mRNA和COX-2 mRNA表达水平。分析全部患者的NOS mRNA和COX-2 mRNA之间的相关性。分析NOS mRNA和COX-2 mRNA对非糜烂性胃食管返流病的诊断价值。结果:四组NOS mRNA和COX-2 mRNA表达水平比较,差异有统计学意义(P<0.05)。两种指标的数值均为C组>B组>A组>对照组(P<0.05)。全部患者的NOS mRNA与COX-2mRNA呈正相关(r=0.500,P<0.05)。利用NOS mRNA和COX-2 mRNA对非糜烂性胃食管返流病患者进行诊断,最佳截断值分别为1.38和1.56,AUC分别为0.794和0.838,灵敏度分别为76.27%和64.41%,特异度分别为73.76%和88.65%,约登指数为0.500和0.531。结论:NOS和COX-2在胃食管返流病不同亚型的患者人群中均呈现明显的高表达状态,其中以Barrett食管患者的表达水平最高,其次为返流性食管炎患者,非糜烂性胃食管返流病患者的表达水平最低。NOS和COX-2对非糜烂性胃食管返流病的诊断具有一定的价值。

Objective: To explore the expression levels and significance of nitric oxide synthase(NOS and cyclooxygenase-2(COX-2) in different types of gastroesophageal reflux disease. Method: The clinical data of 200 patients with gastroesophageal reflux disease admitted to General Hospital of Anshan Iron and Steel Group Corporation from January 2017 to January 2020 were retrospectively analyzed. According to the diagnosis results of patients, all patients with gastroesophageal reflux disease were divided into three groups, non-erosive gastroesophageal reflux disease was group A(n=73), reflux esophagitis was group B(n=68), and Barrett’s esophagus was group C(n=59). 80 patients who underwent physical examination in the same period were selected as the control group. The expression levels of NOS mRNA and COX-2 mRNA in four groups were compared. The correlation between NOS mRNA and COX-2 mRNA in all patients was analyzed. The diagnostic value of NOS mRNA and COX-2 mRNA in non-erosive gastroesophageal reflux disease were analyzed. Result: The expression levels of NOS mRNA and COX-2 mRNA in the four groups were significantly different(P<0.05). The values of the two indexes were group C>group B>group A>control group(P<0.05). NOS mRNA was positively correlated with COX-2mRNA in all patients(r=0.500, P<0.05). The optimal cut-off values were 1.38 and 1.56, AUC was 0.794 and 0.838, sensitivity was 76.27% and 64.41%, specificity was 73.76% and 88.65%, the Yoden index was 0.500 and 0.531 respectively, with NOS and COX-2 mRNA for the diagnosis of patients with non-erosive gastroesophageal reflux disease. Conclusion: The expression levels of NOS and COX-2 in patients with different subtypes of gastroesophageal reflux disease are significantly highly, with the highest expression level in patient with Barrett’s esophagus, follow by patients with reflux esophagitis and the lowest expression level in patients with non-erosive gastroesophageal reflux disease. NOS and COX-2 are valuable in the diagnosis of non-erosive gastroesophageal reflux disease.