中华全科医学2024，Vol.22Issue(5) ：772-775,804.DOI:10.16766/j.cnki.issn.1674-4152.003500

血清胃蛋白酶原对持续幽门螺杆菌感染无症状患者的诊断价值

Diagnostic performance of serum pepsinogen in asymptomatic patients with persistent Helicobacter pylori infection

周桃梅 刘思宇 戴木根
中华全科医学2024，Vol.22Issue(5) ：772-775,804.DOI:10.16766/j.cnki.issn.1674-4152.003500
✕
  • 维普
  • 万方数据

血清胃蛋白酶原对持续幽门螺杆菌感染无症状患者的诊断价值

Diagnostic performance of serum pepsinogen in asymptomatic patients with persistent Helicobacter pylori infection

周桃梅 1刘思宇 2戴木根1
扫码查看

作者信息

  • 1. 温州医科大学附属第五医院消化内科,浙江丽水 323000
  • 2. 温州医科大学附属第五医院检验科
  • 折叠

摘要

目的 探讨胃蛋白酶原(PG)用于检测幽门螺杆菌(H.pylori)持续感染的无症状患者的价值,以期将血清胃蛋白酶原检测用于胃癌高危患者的筛查.方法 选取2021年1月-2022年12月于温州医科大学附属第五医院行胃镜检查的患者(n=583)为研究对象,入组在胃镜检查当天同时接受13C尿素呼吸测试(13C-UBT)和血清胃蛋白酶原检测进行胃癌筛查的无症状受试者.结果 在583名受试者中,UBT检测阳性患者206人(35.33％),血清PG Ⅰ和PG Ⅱ水平高于未感染人群,PG Ⅰ/Ⅱ比率低于未感染人群(P＜0.05).Logistic回归分析显示,在单因素分析中H.pylori感染和PG Ⅰ、PG Ⅱ及PGⅠ/Ⅱ比率相关(P＜0.05),还与年龄、糖尿病相关(P＜0.001);多因素分析显示,血清 PG Ⅱ(OR=1.293,95％CI:0.932～2.085,P＜0.001)和 PG Ⅰ/Ⅱ 比率(OR=0.594,95％CI:0.343～0.978,P＜0.001)是 H.pylori 持续感染的影响因素.血清 PG Ⅱ 水平＞13.59 μg/L(AUC=0.934,灵敏度为87.5％,特异性为91.7％)和PG Ⅰ/Ⅱ比率＜4.85(AUC=0.890,灵敏度为86.8％,特异性为81.6％)与H.pylori感染有关.PG Ⅰ/Ⅱ比率与年龄呈负相关关系(r=-0.167,P=0.041).≥50岁的老年受试者(＜4.27;AUC=0.865,灵敏度为80.7％,特异性为88.2％)的PG Ⅰ/Ⅱ比率的cut-off值低于50岁以下年轻受试者(＜4.85;AUC=0.903,灵敏度为 87.4％,特异性为 82.9％).结论 血清 PG Ⅱ 水平＞13.59 μg/L,PG Ⅰ/Ⅱ 比率＜4.85表明无症状受试者持续感染,应考虑进行幽门螺杆菌13C-UBT确认测试.与年轻受试者相比,年龄≥50岁的老年受试者需要更严格的标准(PG Ⅰ/Ⅱ比率＜4.27)来检测持续感染.

Abstract

Objective This study aimed to explore serum pepsinogen(PG)detection results in asymptomatic patients with persistent Helicobacter pylori(H.pylori)infection,with the potential application of serum PG detection for screen-ing high-risk gastric cancer patients.Methods A total of 583 patients who underwent gastroscopy at the Fifth Affiliated Hospital of Wenzhou Medical University between January 2021 and December 2022 were included in this study.Among them,asymptomatic individuals who underwent 13C urea breath test(13C-UBT)and serum PG detection for cancer screening on the same day of gastroscopy were enrolled.Results Out of the 583 subjects,206 patients(35.33％)test-ed positive for the 13C-UBT,exhibiting higher levels of serum PG Ⅰ and PG Ⅱ compared to the uninfected population.Additionally,their PG Ⅰ/Ⅱ ratios were lower than those observed in the uninfected population(P＜0.05).Univariate logistic regression analysis showed that H.pylori infection was associated with PG Ⅰ,PG Ⅱ,and PG Ⅰ/Ⅱ ratio(P＜0.05),as well as age and diabetes(P＜0.001).In the multivariate analysis,only serum PG Ⅱ(OR=1.293,95％CI:0.932-2.085,P＜0.001)and PG Ⅰ/Ⅱ ratio(OR=0.594,95％CI:0.343-0.978,P＜0.001)remained as inde-pendent risk factors for persistent H.pylori infection.A serum PG Ⅱ level＞13.59 μg/L(AUC=0.934,sensitivity 87.5％,specificity 91.7％)and a PG Ⅰ/Ⅱ ratio＜4.85(AUC=0.890,sensitivity 86.8％,specificity 81.6％)are associated with H.pylori infection.Further,the PG Ⅰ/Ⅱ ratio showed an inverse correlation with age(r=-0.167,P=0.041).Notably,the cut-off value of PG Ⅰ/Ⅱ ratio in elderly subjects aged 50(＜4.27;AUC=0.865,sensitivity 80.7％,specificity 88.2％)was lower than that in young subjects under 50(＜4.85;AUC=0.903,sensitivity 87.4％,specificity 82.9％).Conclusion Serum PG Ⅱ level＞13.59 ng/mL,PG Ⅰ/Ⅱ ratio＜4.85 indicates persistent infec-tion in asymptomatic subjects,and consideration should be given to conducting Helicobacter pylori 13C-UBT confirmation testing.Compared to young subjects,elderly subjects aged ≥ 50 years require stricter standards(PG Ⅰ/Ⅱ ratio＜4.27)to detect persistent infections.

关键词

幽门螺杆菌/感染/血清胃蛋白酶原/胃癌

Key words

Helicobacter pylori/Infection/Serum pepsinogen/Gastric cancer

引用本文复制引用

基金项目

浙江省中医药科技计划(2022ZB406)

出版年

2024
中华全科医学
中华预防医学会,安徽省全科医学会

中华全科医学

CSTPCD
影响因子：1.688
ISSN：1674-4152
参考文献量27
段落导航相关论文