目的 探讨胃蛋白酶原和胃泌素对自身免疫性胃炎(AIG)与幽门螺杆菌(Hp)相关萎缩性胃炎的鉴别价值。方法 回顾性分析2022-01至2025-12在武警河南总队医院治疗的115例AIG患者(AIG组)临床资料,同时选取Hp相关萎缩性胃炎患者(Hp相关萎缩性胃炎组)108例和健康体检者100例(健康组)。比较三组患者的一般情况、胃蛋白酶原Ⅰ和Ⅱ、胃泌素水平差异,分析胃蛋白酶原、胃泌素鉴别AIG与Hp相关萎缩性胃炎的价值。结果 AIG组女性占比56.52%,明显高于Hp相关萎缩性胃炎组和健康组,差异有统计学意义(P＜0.05);AIG组胃蛋白酶原Ⅰ为(15.56±5.56)μg/L,明显低于Hp相关萎缩性胃炎组和健康组(P＜0.05),而胃泌素为(183.34±72.23)ng/L,显著高于Hp相关萎缩性胃炎组和健康组,差异有统计学意义(P＜0.05);AIG组胃蛋白酶原Ⅱ为(7.10±2.12)μg/L,低于健康组,差异有统计学意义(P＜0.05),与Hp相关萎缩性胃炎组比较差异无统计学意义;胃蛋白酶原Ⅰ、胃泌素鉴别AIG和Hp相关萎缩性胃炎的ROC曲线下面积分别为0.871(95%CI:0.822~0.920)和0.899(95%CI:0.858~0.940),差异有统计学意义(P＜0.001)。结论 胃蛋白酶原Ⅰ和胃泌素对AIG与Hp相关萎缩性胃炎具有良好的鉴别价值。
Abstract
Objective To explore the differential diagnostic value of pepsinogen and gastrin in patients with autoimmune gastritis(AIG)and helicobacter pylori (Hp)-associated atrophic gastritis. Methods A retrospective analysis was conducted on clinical data of 115 patients diagnosed with AIG (AIG group) in Henan Provincial Corps Hospital of Chinese People's Armed Police Force from January 2022 to December 2025. Additionally,108 patients with Hp-associated atrophic gastritis (Hp-associated atrophic gastritis group) and 100 healthy individuals (healthy group) were selected for comparison. The differences in general features, serum levels of pepsinogen I and II, and gastrin among the three groups were analyzed to assess the differential diagnostic value on pepsinogen and gastrin in differentiating AIG from Hp-associated atrophic gastritis. Results Females accounted for 56.52% of the AIG group, significantly higher than those in the Hp-associated atrophic gastritis group and the healthy group (P<0.05). The level of pepsinogen I in the AIG group was (15.56±5.56) μg/L, which was markedly lower than those in in the other two groups (P<0.05), while, the gastrin level was (183.34±72.23) ng/L, significantly higher than those in the other two groups (P<0.05). The level of pepsinogen Ⅱ in the AIG group was (7.10±2.12) μg/L, which was lower than that in the healthy group (P<0.05), but showed no statistically significant difference compared with the Hp-associated atrophic gastritis group. The receiver operating characteristic (ROC) curve analysis revealed that the areas under the ROC curves for pepsinogen I and gastrin in differentiating AIG from HP-associated atrophic gastritis were 0.871 (95% CI: 0.822-0.920) and 0.899 (95% CI: 0.858-0.940), respectively, both showing statistical significance (P<0.001). Conclusions Serum levels of pepsinogen I and gastrin differ significantly between AIG and Hp-associated atrophic gastritis patients, indicating that pepsinogen I and gastrin have good differential diagnostic value for these two diseases.
关键词
自身免疫性胃炎 /
幽门螺杆菌相关萎缩性胃炎 /
胃蛋白酶原 /
胃泌素 /
鉴别价值
Key words
autoimmune gastritis /
helicobacter pylori associated atrophic gastritis /
pepsinogen /
gastrin /
differential diagnostic value
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