摘要
目的探讨胃幽门螺杆菌(Helicobacter pylori,Hp)感染联合胃泌素-17 (Gastrin-17,G-17)、胃蛋白酶原Ⅰ(PepsinogenⅠ,PGⅠ)、胃蛋白酶原Ⅱ(PepsinogenⅡ,PGⅡ)检查对赣南地区健康体检人群胃部病变情况的初筛价值。方法 2019年1月-2019年12月于赣州市人民医院行健康体检的体检者共3 756名,根据纳排标准纳入513名,均接受尿素[14C]呼气试验检查和胃功能三项检查,对Hp、G-17、PGⅠ、PGⅡ任一指标检测异常的342例体检者行胃镜检查,确定是否存在胃部病变。分析Hp阳性与G-17、PGⅠ、PGⅡ水平的关系,分析Hp阳性、G-17、PGⅠ、PGⅡ水平与胃部疾病发生的关系及初筛价值,探讨本地区胃部疾病发生的影响因素。结果 513名健康体检人群经检查,Hp感染者占41.91%,Hp阳性组G-17水平高于Hp阴性组,PGⅠ、PGⅡ水平低于Hp阴性组(均P<0.05),Hp阳性与G-17呈正相关,与PGⅠ、PGⅡ水平呈负相关(均P<0.05);342例行胃镜及病理组织活检者中,101例存在胃部病变,胃部疾病组Hp阳性率、G-17水平高于非胃部疾病组,PGⅠ水平低于非胃部疾病组(均P<0.05);性格温和是胃部疾病发生的独立保护因素(P<0.05),心理压力大、吸烟、饮酒、家族胃病遗传史、饮食习惯不健康、Hp阳性、G-17水平异常、PGⅠ水平异常是胃部疾病发生的独立危险因素(P<0.05);G-17、PGⅠ单独检查对胃部病变具有一定初筛价值,G-17临界值为16.67 pmol/L,PGⅠ临界值为68.26μg/L。Hp阳性单独诊断对胃部病变初筛价值较低,但与G-17、PGⅠ联合诊断可提高胃部病变初筛准确性。结论健康体检人群采用Hp感染联合G-17、PGⅠ初筛胃部疾病具有较高价值。良好控制情绪、维持健康生活及饮食习惯、正规抗Hp治疗可防治胃部疾病发生。
OBJECTIVE To explore preliminary screening value of gastric Helicobacter pylori(Hp) infection combined with gastrin-17(G-17), pepsinogen I(PGI) and pepsinogen II(PG II) examination for gastric lesions in healthy physical examination people in South Jiangxi area. METHODS Among 3 756 people who underwent physical examination in Ganzhou People’s Hospital from January 2019 to December 2019, 513 cases were enrolled in the study according to inclusion and exclusion criteria. All patients underwent urea[14 C] breath test and 3 items of gastric function and 342 patients with abnormalities in at least one of Hp, G-17, PGI and PGII underwent gastroscopy to determine the presence or absence of gastric lesion. The relationship between positive Hp and G-17, PGI, PGII levels was analyzed. The correlation between Hp positive, G-17, PGI, PGII levels and occurrence of gastric diseases was analyzed, and their preliminary screening value was evaluated. The risk factors of gastric diseases in this area were explored. RESULTS In 513 healthy people undergoing physical examination, there were 215 cases with Hp infection, accounting for 41.91%. The level of G-17 in the Hp positive group was significantly higher than that in the Hp negative group, whereas levels of PGI and PGII were lower than that in HP negative group(P<0.05). Hp positive rate was positively correlated with G-17 and negatively correlated with PGI and PGII levels(P<0.05). Among 342 patients undergoing gastroscopy and pathological biopsy, there were 101 cases with gastric lesions. The Hp positive rate and G-17 level in the gastric disease group were significantly higher than that in the non-gastric disease group, but PGI level was significantly lower than that in the non-gastric disease group(P<0.05). There was no significant difference of PGII level between the two groups. Mild personality was an independent protective factor against the occurrence of gastric disease(P<0.05), and heavy psychological stress, smoking, drinking, family genetic history of gastric diseases,
作者
张志英
刘燕
肖美萍
于小洪
林燕
谢宁生
张功亮
ZHANG Zhi-ying;LIU Yan;XIAO Mei-ping;YU Xiao-hong;LIN Yan;XIE Ning-sheng;ZHANG Gong-liang(Ganzhou People's Hospital,Ganzhou,Jiangxi 341000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第16期2411-2415,共5页
Chinese Journal of Nosocomiology
基金
江西省卫健委科技计划基金资助项目(20187254)。
关键词
幽门螺杆菌感染
胃功能检查
健康体检人群
胃部疾病
ROC曲线
Helicobacter pylori infection
Gastric function examination
Healthy physical examination people
Gastric disease
ROC curve
