摘要
目的研究慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者血清解整合素金属蛋白酶17(adisintegrin and metalloproteinase-17,ADAM-17)和C-X-C趋化因子配体16(C-X-C chemokine ligand 16,CXCL16)水平及临床价值。方法选取2018年1月~2020年1月陕西中医药大学附属西电集团医院因腹部不适等症状收治的174例患者,根据病理活检结果分为CAG组(n=94)和非CAG组(n=80)。CAG组根据严重程度分为轻度组(n=27)、中度组(n=30)和重度组(n=37)。以50例健康体检者为对照组。采用酶联免疫吸附试验(ELISA)检测血清ADAM17和CXCL16水平。多因素Logistic回归分析CAG发生的影响因素,受试者工作特征曲线分析血清ADAM17和CXCL16对CAG的诊断价值。结果CAG组血清ADAM17(79.25±9.34ng/L),CXCL16(4.66±0.58μg/L)水平高于非CAG组(73.94±8.26ng/L,4.03±0.55μg/L)和对照组(53.04±7.20ng/L,1.02±0.35μg/L),差异具有统计学意义(t=5.794,24.854;11.053,55.497,均P<0.05)。重度组CAG患者血清ADAM17(87.17±9.30ng/L),CXCL16(5.14±0.51μg/L)水平高于轻度组(79.12±9.52ng/L,4.65±0.57μg/L)和中度组(68.54±7.89ng/L,4.02±0.63μg/L),差异具有统计学意义(t=11.574,5.152;11.065,4.987,均P<0.05)。血清ADAM17(OR=1.851,95%CI:1.350~2.522),CXCL16(OR=1.682,95%CI:1.233~2.296)是影响CAG发生的独立危险因素。血清ADAM17,CXCL16联合诊断CAG的曲线下面积为0.912(95%CI:0.858~0.949),大于单一指标0.843(95%CI:0.801~0.907),0.785(95%CI:0.722~0.834),差异具有统计学意义(Z=9.357,12.894,均P<0.05)。结论CAG患者血清ADAM17,CXCL16升高,两者与CAG疾病程度有关,联合检测对CAG有较高的预测价值。
Objective To study the serum levels of adisintegrin and metalloproteases 17(ADAM17)and C-X-C chemokine ligand 16(CXCL16)in patients with chronic atrophic gastritis(CAG)and their clinical value.Methods A total of 174 patients admitted to Xidian Group Hospital Affiliated to Shaanxi University of Traditional Chinese Medicine from January 2018 to January 2020 due to abdominal discomfort and other symptoms were selected.Based on pathological biopsy results,they were divided into CAG group(n=94)and non CAG group(n=80).The CAG group was divided into mild group(n=27),moderate group(n=30),and severe group(n=37)based on the severity.Meanwhile,50 healthy examinees were used as the control group.Enzyme-linked immunosorbent assay was used to detect serum ADAM17 and CXCL16 levels.Multivariate logistic regression analysis was used to investigate the influencing factors of CAG occurrence,and the diagnostic values of serum ADAM17 and CXCL16 for CAG were analyzed using receiver operating characteristic curves.Results The serum levels of ADAM17(79.25±9.34ng/L)and CXCL16(4.66±0.58μg/L)in CAG group were higher than those in non-CAG group(73.94±8.26ng/L,4.03±0.55μg/L)and control group(53.04±7.20ng/L,1.02±0.35μg/L),and the differences were statistically significant(t=5.794,24.854;11.053,55.497,all P<0.05).The serum levels of ADAM17(87.17±9.30ng/L)and CXCL16(5.14±0.51μg/L)in severe CAG patients were higher than those in mild CAG group(79.12±9.52ng/L,4.65±0.57μg/L)and moderate groups(68.54±7.89ng/L,4.02±0.63μg/L),and the differences were statistically significant(t=11.574,5.152;11.065,4.987,all P<0.05).Serum ADAM17(OR=1.851,95%CI:1.350~2.522)and CXCL16(OR=1.682,95%CI:1.233~2.296)were independent risk factors for CAG.The area under the curve of serum ADAM17 and CXCL16 combined diagnosis of CAG was 0.912(95%CI:0.858~0.949),which was larger than the single indicator of 0.843(95%CI:0.801~0.907)and 0.785(95%CI:0.722~0.834),and the differences were statistically significant(Z=9.357,12.894,all P<0.05).Conclusion The serum levels of ADAM17 and CXCL16 were increased in CAG patients,indicating they may be related to the severity of CAG.The combined detection of ADAM17 and CXCL16 has a high predictive value for CAG.
作者
张鹏飞
杨小飞
许怀利
张萌
ZHANG Pengfei;YANG Xiaofei;XU Huaili;ZHANG Meng(Department of Gastroenterology,Xidian Group Hospital Affiliated to Shaanxi University of Traditional Chinese Medicine,Xi’an 710077,China)
出处
《现代检验医学杂志》
CAS
2024年第1期73-77,共5页
Journal of Modern Laboratory Medicine
基金
陕西省科技厅项目(2021SF-318):内镜检查联合血清指标检测对慢性萎缩性胃炎的价值。
