PGI,PGII,PGI/PGII,G-17在胃溃疡病情进展及预后的预测价值

目的探讨胃蛋白酶原I(PG I)、胃蛋白酶原II(PG II)、PG I/PG II、胃泌素(G-17)在胃溃疡病情进展及预后中的预测价值。方法选取2020年1月至2022年12月胃溃疡患者99例。根据畸田隆夫分期标准,分为活动组(活动期)、愈合组(愈合期)、瘢痕组(瘢痕期)各33例。用全自动化学发光免疫分析仪进行PG I、PG II、PG I/PG II、G-17表达水平的测定,比较三组治疗前后4项指标差异。结果活动组腹痛、食欲不振、嗳气胃胀、恶心呕吐人数占比、VAS评分、PG II、G-17高于愈合组、瘢痕组(P<0.05);活动组PG I、PG I/PG II低于愈合组、瘢痕组(P<0.05)。PG I、PG I/PG II分别与VAS评分呈负相关(r=-0.631、-0.611);PG II、G-17与VAS评分呈正相关(r=0.724、0.706)(P<0.05)。PG I、PG II、PG I/PG II、G-17联合诊断胃溃疡分期的曲线下面积AUC(0.869)高于单一指标(P<0.05)。治疗4周后,预后良好组VAS评分、PG II值、G-17值低于预后不良组,预后良好组PG I、PG I/PG II值高于预后不良组(P<0.05);PG I、PG II、PG I/PG II、G-17联合诊断胃溃疡预后不良的曲线下面积(AUC)为0.889高于单一指标(P<0.05)。结论PG I、PG I/PG II在胃溃疡活动期、预后不良中呈低表达,PG II、G-17在胃溃疡活动期、预后不良中呈高表达,对胃溃疡患者进行4项指标检测,能为其病情、预后诊断提供重要参考依据。

Objective To investigate the diagnostic value of pepsinogen I(PG-I),pepsinogen II(PG II),PG-I/PG II and gastrin(G-17)levels in the development and prognosis of gastric ulcer.Methods 99 patients with gastric ulcer admitted to Tongxiang Fourth People's Hospital from January 2020 to December 2022 were selected as the study objects.According to Teratada's staging criteria,they were divided into the active group(n=33,active stage),the healing group(n=33,healing stage)and the scar group(n=33,scar stage).The expression levels of PG I,PG II,PG I/PG II and G-17 were measured by automatic chemiluminescence immunoassay.The differences of 4 indexes among the three groups and 99 patients before and after treatment were compared,and the application value of 4 indexes in the staging and prognosis of gastric ulcer was discussed.Results The proportion of abdominal pain,loss of appetit e,belching,distension,nausea and vomiting,VAS score,PG II value and G-17 value in the active group were higher than those in the healing group and scar group(P<0.05).The PG-I and PG-I/PG II values in the active group were lower than those in the healing group and scar group(P<0.05).PG I,PG-I/PG II were negatively correlated with VAS scores(r=-0.631,-0.611).PG II and G-17 were positively correlated with VAS scores(r=0.724,0.706)(P<0.05).The area under the curve AUC(0.869)of PG I,PG II,PG I/PG II and G-17 combined diagnosis of gastric ulcer stage was higher than that of single index(P<0.05).After 4 weeks of treatment,the VAS score,PG-II value and G-17 value of the good prognosis group were lower than those of the poor prognosis group,and the PG-I and PG-I/PG-II values of the good prognosis group were higher than those of the poor prognosis group(P<0.05).The area under the curve AUC of PG I,PG II,PG I/PG II and G-17 combined diagnosis of poor prognosis of gastric ulcer was higher(0.889)than that of single index(P<0.05).Conclusion The expression of PG I and PG I/PG II is low in the active stage and poor prognosis of gastric ulcer,while the expression of PG II and G-17 is high in the active stage and poor prognosis of gastric ulcer.The detection of four indicators in patients with gastric ulcer can provide an important reference for the diagnosis of the disease and prognosis.