血清胃蛋白酶原检测诊断消化性溃疡的临床价值

目的探讨血清胃蛋白酶原（PG）检测诊断消化性溃疡（PU）的临床价值。方法采用时间分辨荧光免疫分析法检测98例PU患者和52例健康者的血清PGⅠ、PGⅡ和PGⅠ/PGⅡ,并进行比较。结果与健康者比较,PU患者血清PGⅠ、PGⅡ升高（P〈0.01）,PGⅠ/PGⅡ无明显变化（P〉0.05）。以受试者工作特征曲线分析PGⅠ、PGⅡ对DU的诊断价值,曲线下面积分别为0.79、0.72;PGⅠ205 ng/ml为其最佳诊断阈值,其灵敏度54.1%,特异度94.2%;PGⅡ17.5 ng/ml为其最佳诊断阈值,其灵敏度37.8%,特异度92.3%。结论血清PGⅠ、PGⅡ升高提示患PU的风险增加,PG检测在PU筛查及诊断中均有临床意义,PGⅠ可作为经济实用的PU筛查指标。

Diagnostic significance of serum pepsinogen test in peptic ulcer

Objective To investigate the clinical value of serum pepsinogen（PG） test in the diagnosis of peptic ulcer（PU）.Method The serum PGⅠand PGⅡ levels and PGⅠ/PGⅡ ratio were measured by time-resolved fluorescence immunoassay（TRFIA） in 98 PU patients and 52 healthy controls,and the results were compared.Results PGⅠand PGⅡ levels of PU group were higher than those of control group（P0.01）.PGⅠ/PGⅡ ratio showed no significant difference between two groups（P0.05）.Receiver operating characteristic curve analysis was used to assess the performance of serum PGⅠand PGⅡ levels in diagnosis of PU.The area under the curve of PGⅠ and PGⅡ was 0.79 and 0.72,respectively.The optimal cut-off value of 205 ng/ml for PGⅠ yielded a sensitivity of 54.1% and a specificity of 94.2%,while the optimal cut-off value of 17.5 ng/ml for PGⅡ yielded a sensitivity of 37.8% and a specificity of 92.3%.Conclusion Increased serum PG Ⅰ and PG Ⅱ levels indicate a higher risk of peptic ulcer.Serum PG test is a useful method for PU screening and diagnosis.PGⅠ could be considered as an economic marker for PU screening.