慢性萎缩性胃炎肠化生患者血清胃泌素释放肽前体、糖链抗原242、降钙素原水平与幽门螺杆菌感染及预后的相关性探究

Correlation of serum pro-gastrin-releasing peptide,sugar chain antigen 242,procalcitonin levels in patients with chronic atrophic gastritis with intestinal metaplasia and Helicobacter pylori infection and prognosis

目的探讨慢性萎缩性胃炎(CAG)肠化生患者血清胃泌素释放肽前体(ProGRP)、糖链抗原242(CA242)、降钙素原(PCT)水平与幽门螺杆菌(Hp)感染及预后的相关性。方法回顾性选取应急总医院2016年1月至2019年1月诊治的100例CAG肠化生患者作为研究对象,根据其是否存在Hp感染分为感染组(75例)和非感染组(25例)。比较两组临床资料和血清ProGRP、CA242、PCT水平,分析血清ProGRP、CA242、PCT联合诊断CAG肠化生患者Hp感染的价值及与预后的相关性。结果感染组萎缩程度、肠化生程度高于非感染组(P<0.05)。感染组血清ProGRP、CA242、PCT水平高于非感染组[(159.41±42.38)ng/L比(105.84±18.29)ng/L、(7.24±2.28)kU/L比(4.12±1.30)kU/L、(3.84±1.12)μg/L比(2.57±0.82)μg/L],差异有统计学意义(P<0.05)。相关性分析结果表明,CAG肠化生患者血清ProGRP、CA242、PCT水平与萎缩程度(r=0.614、0.629、0.672)、肠化生程度(r=0.574、0.591、0.603)呈正相关(P<0.05)。血清ProGRP、CA242、PCT联合诊断CAG肠化生患者Hp感染的曲线下面积为0.874(95%CI 0.793~0.932),诊断灵敏度、特异度分别为76.00%、92.00%。血清ProGRP、CA242、PCT联合诊断Hp阳性患者2年内胃肿瘤性病变发生率高于阴性患者,但组间比较差异无统计学意义(P>0.05)。结论CAG肠化生患者血清ProGRP、CA242、PCT水平与Hp感染密切相关,各指标联合检测在Hp感染诊断方面具有较高的应用价值。

Objective To investigate the correlation of serum pro-gastrin-releasing peptide(ProGRP),sugar chain antigen 242(CA242),procalcitonin(PCT)levels in patients with chronic atrophic gastritis(CAG)with intestinal metaplasia and Helicobacter pylori(Hp)infection and prognosis.Methods One hundred patients with CAG intestinal metaplasia in Emergency General Hospital were selected as the research objects,and they were divided into infection group(75 cases)and non-infected group(25 cases)according to whether they had Hp infection.The clinical data,levels of serum ProGRP,CA242,and PCT were compared between the two groups,and the diagnostic value of the combination of serum indicators in the diagnosis of Hp infection in CAG intestinal metaplasia patients and their correlation with prognosis were analyzed.Results The degree of atrophy and intestinal metaplasia in the infected group were higher than those in the non-infected group(P<0.05).The levels of serum ProGRP,CA242 and PCT in the infected group were higher than those in the non-infected group:(159.41±42.38)ng/L vs.(105.84±18.29)ng/L,(7.24±2.28)kU/L vs.(4.12±1.30)kU/L,(3.84±1.12)μg/L vs.(2.57±0.82)μg/L,there were statistical differences(P<0.05).The results of Spearman analysis showed that the levels of ProGRP,CA242,PCT had positive correlation with atrophy degree(r=0.614,0.629,0.672,P<0.05),and had positive correlation with intestinal metaplasia degree(r=0.574,0.591,0.603,P<0.05).The area under the curve(AUC)for the combined diagnosis of Hp infection in patients with CAG intestinal metaplasia by serum ProGRP,CA242,and PCT was 0.874(95%CI 0.793-0.932),the diagnostic sensitivity and specificity were 76.00%and 92.00%,respectively.The incidence of gastric neoplasms in patients with Hp positive combined diagnosis of serum ProGRP,CA242,and PCT within 2 years(11.86%)was higher than that of negative patients(0),but the difference was not statistically significant(P>0.05).Conclusions The levels of serum ProGRP,CA242 and PCT in patients with CAG intestinal metaplasia are closely related to Hp infection.The combination of various indicators has high application value in the diagnosis of Hp infection.