摘要
目的 :探讨唾液胃蛋白酶检测对无症状人群胃食管反流的应用价值。方法 :自2017年2月至2017年8月,共招募了31名无症状志愿者。所有志愿者均接受胃镜检查及24 h食管多通道腔内阻抗-pH(multi-channel intraluminal impedance-pH,MII-pH)监测,且所有志愿者在MII-pH监测期间采集午餐后1 h、晚餐后1 h和晨起空腹时3次唾液样本,应用反流胃蛋白酶(胶体金法)Peptest进行检测。分析唾液胃蛋白酶检测的灵敏度、特异度。分析无症状志愿者中病理性反流组与正常组唾液胃蛋白酶结果的差异。结果:共30名无症状志愿者(16名男性和14名女性)完成了研究。10例(33.3%)经24 h食管MII-pH证实存在病理性反流。午餐后、晚餐后和晨起空腹Peptest检测的灵敏度分别为76.5%、84.6%和63.6%,特异度分别为69.2%、58.8%和73.7%。病理性反流组唾液样本中至少有1个及2个阳性者的比例明显高于正常组(均P<0.05)。病理性反流组晚餐后唾液样本阳性率明显高于正常组(P<0.05)。但2组唾液胃蛋白酶浓度无明显差异。结论:无症状人群中存在一部分病理性反流患者。唾液胃蛋白酶检测对于无症状胃食管反流具有一定的诊断价值。
Objective To investigate the performance of salivary pepsin assay in detection of gastroesophageal reflux in asymptomatic individuals.Methods A total of 31 asymptomatic volunteers were recruited from February 2017 through August 2017 and examined with gastroscopy and 24-hour esophageal multi-channel intraluminal impedance-pH(MII-pH)monitoring.The saliva samples were collected upon three occasions during MII-pH monitoring,1 h after lunchtime,1 h after dinner and awakening.The saliva samples were tested with Peptest lateral flow device,and the sensitivity and specificity of salivary pepsin assay were determined.The salivary pepsin was compared between subjects with pathological reflux and normal control.Results Thirty consecutive asymptomatic individuals(16 males and 14 females)had completed the study.Pathological gastroesophageal reflux was confirmed in 10 cases(33.3%)by 24-hour esophageal MII-pH.The sensitivity of peptest were 76.5%,84.6%and 63.6%for samples collected upon lunchtime,dinner and awakening;and the specificity were 69.2%,58.8%and 73.7%,respectively.Individuals with pathological reflux were more likely to have saliva sample positive findings than normal control(P<0.05),particularly with samples acquired after dinner(P<0.05).However,the concentration of pepsin in saliva was not significantly different between the two groups.Conclusions Individuals with pathological reflux could be asymptomatic,and the medical condition can be revealed with Peptest.
作者
汤玉茗
黄佳
朱颖
赵雨娉
钟捷
姚玮艳
TANG Yuming;HUANG Jia;ZHU Ying;ZHAO Yuping;ZHONG Jie;YAO Weiyan(Department of Gastroenterology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《内科理论与实践》
2019年第4期235-238,共4页
Journal of Internal Medicine Concepts & Practice
基金
上海交通大学“科技创新专项资金”多学科交叉项目培育(医工)(项目编号:YG2016QN64)
