系统性硬化症继发胃肠道受累与胃蛋白酶原、胃泌素的相关分析

陈园园; 屠文震; 陈冬冬; 于伶; 王蕾; 李小玲; 张嘉倩; 于文文; 赵荫环

doi:10.3969/j.issn.1671-038X.2022.05.06

系统性硬化症继发胃肠道受累与胃蛋白酶原、胃泌素的相关分析

- 上海市中西医结合医院风湿科(上海，200086)
基金项目:
2020年度上海市虹口区卫生健康委员会中医药科研课题(No：HKQ-ZYY-2020-39)

详细信息

通讯作者: 赵荫环，E-mail：zhaoyinhuan@medmail.com.cn

中图分类号: R593.2

收稿日期: 2022-01-25

刊出日期: 2022-05-15

Correlation analysis of pepsinogen and gastrin in secondary gastrointestinal involvement in systemic sclerosis

- Department of Rheumatology, Shanghai Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, 200086, China

More Information

Corresponding author: ZHAO Yinhuan, E-mail: zhaoyinhuan@medmail.com.cn

Received Date: 25 January 2022

Publish Date: 15 May 2022

摘要

摘要: 目的分析系统性硬化症(SSc)继发胃肠道受累与胃蛋白酶原(PG)、胃泌素(GAS)的相关性。方法选取2020年12月-2021年12月在上海市中西医结合医院风湿科住院诊治的102例SSc患者，其中继发胃肠道受累者64例，未继发胃肠道受累者38例，比较2组间患者性别、年龄、病程、SSc分型及胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及胃蛋白酶原比值(PGR)等差异。结果 102例SSc患者中，男13例(12.75%)，女89例(87.25%)；年龄20~70岁，平均(48.63±11.35)岁；病程6~444个月，平均(116.11±91.06)个月；胃肠道分级中0级38例，1级12例，2级49例，3级3例。不同胃肠道受累评分级间的性别、年龄及病程分布差异无统计学意义(P>0.05)。同时不同组别中PGⅠ、PGⅡ差异有统计学意义(P< 0.05)，可见随胃肠道受累程度加重，PGⅠ及PGⅡ呈上升趋势。而GAS、PGR在各组中差异无统计学意义(P>0.05)。结论血清PGⅠ、PGⅡ测定可作为评估SSc胃肠道受累程度的一种无创、可重复性高的辅助手段。
- 系统性硬化症 /
- 胃肠道受累 /
- 胃蛋白酶Ⅰ /
- 胃蛋白酶Ⅱ /
- 胃泌素
Abstract: Objective To analyze the correlation between pepsinogen(PG), gastrin(GAS) and gastrointestinal involvement in systemic sclerosis(SSc).Methods The data of 102 patients with SSc who were hospitalized in the Department of Rheumatology, Shanghai Integrated Traditional Chinese and Western Medicine Hospital from December 2020 to December 2021 were selected for retrospective analysis. Among them, 64 patients had secondary gastrointestinal tract involvement, and 38 patients had no gastrointestinal tract involvement. The gender, age, disease duration, SSc type, pepsinogen Ⅰ(PGⅠ), pepsinogen Ⅱ(PGⅡ), and pepsinogen ratio(PGR) were compared between the two groups.Results Among the 102 SSc patients, there were 13 males(12.75%) and 89 females(87.25%). In the gastrointestinal tract classification, 38 patients were grade 0, 12 patients were grade 1, 49 patients were grade 2, and only 3 patients were grade 3. The age ranged from 20 to 70(48.63±11.35) years old; the disease duration was 6 to 444(116.11±91.06) months. There was no difference in gender distribution, age distribution and disease course distribution among different gastrointestinal involvement scores(P>0.05). At the same time, the differences in PGⅠ and PGⅡ in different groups were statistically significant(P< 0.05). It can be seen that with the severity of gastrointestinal involvement, PGⅠ and PGⅡ showed an upward trend. However, there were no significant differences in GAS and PGR among the groups(P>0.05).Conclusion The determination of serum PGⅠ and PGⅡ can be used as a non-invasive and highly reproducible auxiliary method for evaluating the degree of gastrointestinal involvement in SSc.
- systemic sclerosis /
- gastrointestinal involvement /
- pepsin Ⅰ /
- pepsin Ⅱ /
- gastrin

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表 1 不同组别患者基本临床资料比较

胃肠道受累评分/分	性别/例(%)		年龄/岁	病程/月
胃肠道受累评分/分	男	女	年龄/岁	病程/月
0	4(3.92)	34(33.33)	49.00(41.00，57.00)	90.00(48.00，144.00)
1	2(1.96)	10(9.80)	49.50(45.50，52.50)	72.00(53.00，216.00)
2	7(6.86)	42(41.17)	48.00(41.00，59.00)	96.00(54.00，168.00)
3	0	3(2.94)	57.00(49.50，57.00)	125.00(92.50，266.50)
χ²	0.877		0.458	1.132
P	0.831		0.928	0.769

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表 2 不同组别血清GAS、PGⅠ、PGⅡ及PGR比较 M(Q₁，Q₃)

胃肠道评分/分	例数	GAS/(pg·mL^-1)	PGⅠ/(pg·L^-1)	PGⅡ/(pg·L^-1)	PGR
0	38	58.04(49.06，70.89)	164.70(148.00，170.10)	11.50(9.70，16.60)	13.20(9.25，17.00)
1	12	51.40(46.19，84.77)	161.90(151.90，168.00)	16.10(14.00，23.20)	11.50(6.40，12.25)
2	49	52.81(44.88，63.90)	171.80(156.50，182.00)	17.90(11.50，20.80)	10.20(8.40，14.70)
3	3	45.90(45.81，58.78)	194.80(180.80，197.20)	32.80(24.80，39.15)	5.90(5.15，7.90)
χ²		1.609	8.737	9.452	7.472
P		0.657	0.033	0.024	0.058

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表 3 SSc-GERD与SSc-非GERD的一般资料分析

组别	例数	性别/例(%)		年龄/岁	病程/月
组别	例数	男	女	年龄/岁	病程/月
SSc-GERD	33	0	33(32.35)	48.76±10.15	96.00(60.00, 126.00)
SSc-非GERD	69	13(12.75)	56(54.90)	48.57±11.96	84.00(48.00, 156.00)
χ²/t/Z		7.126		-0.08	-0.988
P		0.008		0.937	0.323

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表 4 SSc-GERD诊断与血清胃肠激素相关性分析 M(Q₁，Q₃)

组别	例数	GAS/(pg·mL^-1)	PGⅠ/(pg·L^-1)	PGⅡ/(pg·L^-1)	PGR
SSc-GERD	33	52.81(45.14，66.89)	166.8(152.10，180.40)	16.40(11.10，19.50)	10.30(8.10，15.20)
非SSc-GERD	69	55.71(48.42，67.58)	167.7(54.90，177.25)	14.30(9.85，20.50)	12.00(8.45，16.35)
Z		-0.400	-0.174	-0.799	-0.766
P		0.690	0.862	0.424	0.444

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表 5 lcSSc和dcSSc的抗体分布比较例

组别	ATA	ACA	nRNP	SSA	PM-Scl	χ²	P
弥漫型	43	4	9	18	1	5.536	0.237
肢端型	28	9	9	23	1	5.536	0.237

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