血清PCSK9 LTB4 ADAM17与慢性萎缩性胃炎患者病情进展的相关性分析OA
Correlation Analysis of Serum PCSK9 LTB4 and ADAM17 Levels with Disease Progression in Patients with Chronic Atrophic Gastritis
目的:探讨慢性萎缩性胃炎(CAG)患者血清前蛋白转化酶枯草溶菌素 9(PCSK9)、白三烯B4(LTB4)、解整合素金属蛋白酶17(ADAM17)水平与病情进展的相关性,并分析其对病情进展的预测价值.方法:选取2021 年1 月至2023 年1 月CAG患者210 例进行前瞻性研究,依据治疗后2 年内是否发生病情进展分为进展组、无进展组.比较两组临床资料、血清 PCSK9、LTB4、ADAM17 水平.采用Logistic回归分析及限制性立方样条模型(RCS)曲线分析血清 PCSK9、LTB4、ADAM17 对病情进展的关系并进行分层分析.采用受试者工作特征(ROC)曲线评价血清 PCSK9、LTB4、ADAM17 对病情进展的预测价值.结果:进展组Hp感染占比、饮酒史占比、饮食辛辣占比高于无进展组,PGⅠ/PGⅡ比值低于无进展组(P<0.05);进展组血清PCSK9、LTB4、ADAM17 水平分别为(188.73±30.17)ng/mL、(9.52±2.06)pg/mL、(74.56±12.25)ng/L,明显高于无进展组的(160.49±25.64)ng/mL、(7.78±1.51)pg/mL、(63.17±9.44)ng/L(P<0.05);将 Hp 感染、饮酒史、饮食辛辣、PGⅠ/PGⅡ比值等其他因素剔除,血清PCSK9、LTB4、ADAM17 仍是 CAG 病情进展的的独立影响因素(P<0.05);当血清 PCSK9≥144.69ng/mL、LTB4≥7.01pg/mL、ADAM17≥67.16ng/L 时与 CAG 病情进展显著相关(P<0.05);血清 PCSK9、LTB4、ADAM17 与Hp感染、PGⅠ/PGⅡ比值在 CAG 病情进展中存在交互影响(交互 P<0.05);血清PCSK9、LTB4、ADAM17 单项及联合预测CAG病情进展的AUC分别为0.763、0.755、0.780、0.918,且联合预测的AUC明显高于单一指标预测(P<0.05).结论:CAG 病情进展患者血清 PCSK9、LTB4、AD-AM17 水平升高,且与CAG病情进展显著相关,联合检测其水平对CAG病情进展具有一定预测价值.
Objective:To investigate the correlation between the levels of serum proprotein convertase subtilase 9(PCSK9),leukotriene B4(LTB4),and a disintegrin and metalloproteinase 17(ADAM 17)in pa-tients with chronic atrophic gastritis(CAG)and disease progression,and analyze their predictive value for disease progression.Methods:A prospective study was conducted on 210 patients with CAG from January 2021 to January 2023.Patients were divided into a progression group and a non-progression group based on whether they experienced disease progression within 2 years after treatment.The clinical data,serum levels of PCSK9,LTB4,and ADAM17 were compared between the two groups.Logistic regression analysis and restricted cubic spline(RCS)curve analysis were used to analyze the relationship between serum PCSK9,LTB4,and AD-AM17 and disease progression,and stratified analysis was conducted.The predictive value of serum PCSK9,LTB4,and ADAM17 for disease progression was evaluated using the receiver operating characteristic(ROC)curve.Results:The proportion of Hp infection,alcohol consumption history,and spicy diet in the progression group were higher than those in the non-progression group,while the PGⅠ/PGⅡ ratio was lower than that in the non-progression group(P<0.05);the levels of serum PCSK9,LTB4,and ADAM17 in the progression group were(188.73±30.17)ng/mL,(9.52±2.06)pg/mL,and(74.56±12.25)ng/L,respectively,which were significantly higher than those in the non-progression group(160.49±25.64)ng/mL,(7.78±1.51)pg/mL,and(63.17±9.44)ng/L(P<0.05);after excluding other factors such as Hp infection,alcohol consumption history,spicy diet,and PGⅠ/PGⅡ ratio,serum PCSK9,LTB4,and ADAM17 remained inde-pendent factors for the progression of CAG(P<0.05);when serum PCSK9 was≥144.69 ng/mL,LTB4 was≥7.01 pg/mL,and ADAM17 was≥67.16 ng/L,there was a significant correlation with the progression of CAG(P<0.05);there was an interactive effect between serum PCSK9,LTB4,ADAM17,Hp infection,and PGⅠ/PGⅡ ratio in the progression of CAG(interaction P<0.05);the AUCs of serum PCSK9,LTB4,AD-AM17,and their combination for predicting the progression of CAG were 0.763,0.755,0.780,and 0.918,respectively,and the AUC of the combination was significantly higher than that of the single index(P<0.05).Conclusion:The levels of serum PCSK9,LTB4,and ADAM17 increase in patients with CAG progres-sion,and are significantly correlated with CAG progression.Combined detection of their levels has certain pre-dictive value for CAG progression.
由昭阳;李石背;罗润;陈宇航;牟娅宁
云南省滇南中心医院/红河州第一人民医院消化内科,云南 蒙自 661100云南省滇南中心医院/红河州第一人民医院消化内科,云南 蒙自 661100云南省滇南中心医院/红河州第一人民医院消化内科,云南 蒙自 661100云南省滇南中心医院/红河州第一人民医院消化内科,云南 蒙自 661100云南省滇南中心医院/红河州第一人民医院消化内科,云南 蒙自 661100
慢性萎缩性胃炎前蛋白转化酶枯草溶菌素9白三烯B4解整合素金属蛋白酶17
Chronic atrophic gastritisProprotein convertase subtilisin 9Leukotriene B4Dis-integrin and metalloproteinase 17
《河北医学》 2026 (1)
62-69,8
云南省卫生健康委临床医学中心2021-2023年建设项目,(编号:202101AF160093)
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