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目的通过检测慢性萎缩性胃炎患者血清胃蛋白酶原Ⅰ(PGⅠ)和胃蛋白酶原Ⅱ(PGⅡ)水平,探讨血清胃蛋白酶原对萎缩性胃炎的诊断价值。方法以我院消化内科行胃镜检查且符合入选标准的慢性萎缩性胃炎患者160例(萎缩性胃炎组)为研究对象,以同期健康体检者60例作为对照组,采用放射免疫测定法(RIA)测定血清PGⅠ、PGⅡ水平,观察其与慢性萎缩性胃炎的相关性。结果 (1)与对照组相比,萎缩性胃炎组PGⅠ水平明显下降,差异有统计学意义(P=0.000);而PGⅡ水平差异无统计学意义(P=0.669)。(2)PGⅠ诊断慢性萎缩性胃炎的受试者工作特征曲线(ROC)下面积为0.851(95%CI:0.789~0.912)。(3)当PGⅠ≤88.03μg/L时,诊断慢性萎缩性胃炎的敏感度、特异度、阳性预测值、阴性预测值、一致率分别是76.25%、80.00%、90.39%、70.77%和85.00%。结论血清PGⅠ水平可作为慢性萎缩性胃炎和胃癌人群的早期筛查和辅助性诊断的血清学指标。
Objective To detect the serum levels of pepsinogen Ⅰ (PG Ⅰ) and pepsinogen Ⅱ (PG Ⅱ) in patients with chronic atrophic gastritis and to evaluate the value of serum pepsinogen in the diagnosis of atrophic gastritis. Methods 160 patients with chronic atrophic gastritis (atrophic gastritis group) underwent gastroscopy and met the inclusion criteria were enrolled in this study. Sixty healthy subjects were selected as control group. Radioimmunoassay (RIA) Serum PG Ⅰ and PG Ⅱ levels were measured and their correlations with chronic atrophic gastritis were observed. Results (1) Compared with the control group, the PG Ⅰ level in atrophic gastritis group was significantly decreased (P = 0.000), while there was no significant difference in PG Ⅱ level (P = 0.669). (2) The area under the receiver operating characteristic curve (ROC) of PGI in diagnosing chronic atrophic gastritis was 0.851 (95% CI: 0.789-0.912). (3) The sensitivity, specificity, positive predictive value, negative predictive value and concordance rate of diagnosis of chronic atrophic gastritis were 76.25%, 80.00%, 90.39%, 70.77% and 85.00% when PGⅠ≤88.03μg / . Conclusion Serum PGⅠ level can be used as a serological marker for early screening and adjuvant diagnosis of patients with chronic atrophic gastritis and gastric cancer.