| 张志平,邢瑞青,陈慧昱,李 静,刘家云.血清球蛋白/胆碱酯酶（G/C）及VEGF在不同病情严重程度肝硬化门脉高压性胃病患者中的表达差异及其疾病诊断价值分析[J].,2024,(18):3442-3446 |
| 血清球蛋白/胆碱酯酶（G/C）及VEGF在不同病情严重程度肝硬化门脉高压性胃病患者中的表达差异及其疾病诊断价值分析 |
| Differential Expression and Diagnostic Value of Serum Globulin/Cholinesterase (G/C) and VEGF in Patients with Different Severity of Liver Cirrhosis and Portal Hypertensive Gastric Disease |
| 投稿时间：2024-02-03 修订日期：2024-02-27 |
| DOI：10.13241/j.cnki.pmb.2024.18.007 |
| 中文关键词: 血清球蛋白/胆碱酯酶 血管内皮细胞生长因子 肝硬化门脉高压性胃病 肝硬化 诊断价值 |
| 英文关键词: Serum globulin/cholinesterase Vascular endothelial cell growth factor Cirrhotic portal hypertensive gastropathy Liver cirrhosis Diagnostic value |
| 基金项目:陕西省重点研发计划基金项目（2023-YBSF-657） |
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| 中文摘要: |
| 摘要 目的：探讨血清球蛋白/胆碱酯酶（G/C）及血管内皮细胞生长因子（VEGF）在不同病情严重程度肝硬化门脉高压性胃病患者中的表达差异及其疾病诊断价值。方法：选取我院2020年12月到2023年12月收治的80例肝硬化门脉高压性胃病患者作为研究对象，依照患者肝硬化门脉高压性胃病严重程度进行分组，分为轻度组（n=45）及重度组（n=35），另选取同期收治的肝硬化门脉高压未合并胃病的40例患者作为对照组。对比三组患者临床资料及G/C、VEGF表达水平，采取logistics回归模型分析肝硬化门脉高压性胃病的独立影响因素，并采用Pearson检验分析G/C、VEGF与不同病情严重程度肝硬化门脉高压性胃病的相关性，最后建立受试者工作特征（ROC）曲线分析G/C、VEGF对肝硬化门脉高压性胃病的诊断价值。结果：三组患者性别、年龄、合并基础疾病、病因、Child-Pugh分级、AST、ALT水平对比无明显差异（P＞0.05），肝硬化病程、Hb、PLT、Alb、G/C、VEGF水平对比差异显著（P＜0.05）；G/C升高、VEGF降低为肝硬化门脉高压性胃病的独立影响因素（P<0.05）；G/C（r=0.493）、VEGF（r=-0.542）的表达均与肝硬化门脉高压性胃病严重程度密切相关（P<0.05）；VEGF对肝硬化门脉高压性胃病的诊断曲线下面积为0.822，最佳诊断界限值为143.45 ng/mL。G/C对肝硬化门脉高压性胃病的诊断曲线下面积为0.875，最佳诊断界限值为0.87。两者联合的曲线下面积为0.932。G/C联合VEGF对肝硬化门脉高压性胃病的诊断灵敏度与特异度明显高于单一指标（P＜0.05）。结论：G/C、VEGF为肝硬化门脉高压性胃病的独立影响因素，且与不同病情严重程度具有显著关系，两者联合可提升度肝硬化门脉高压性胃病的诊断效能。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the differential expression and diagnostic value of serum globulin/cholinesterase (G/C) and vascular endothelial cell growth factor (VEGF) in patients with different severity levels of cirrhosis and portal hypertensive gastric disease. Methods: 80 patients with cirrhotic portal hypertension and gastric disease admitted to our hospital from December 2020 to December 2023 were selected as the study subjects. They were divided into mild group (n=45) and severe group (n=35) according to the severity of the disease. Additionally, 40 patients with cirrhotic portal hypertension and no accompanying gastric disease admitted during the same period were selected as the control group. Compare the clinical data and G/C, VEGF expression levels of three groups of patients, use logistic regression model to analyze the independent influencing factors of cirrhotic portal hypertension gastric disease, and use Pearson test to analyze the correlation between G/C, VEGF and different severity of cirrhotic portal hypertension gastric disease. Finally, establish ROC curve to analyze the diagnostic value of G/C, VEGF for cirrhotic portal hypertension gastric disease. Results: There were no differences in gender, age, comorbidities, etiology, Child Pugh grading, AST, and ALT levels among the three groups of patients (P>0.05), while there were differences in the course of liver cirrhosis, Hb, PLT, Alb, G/C, and VEGF levels (P<0.05); Elevated G/C and decreased VEGF were independent influencing factors for portal hypertensive gastric disease in liver cirrhosis(P<0.05); The expression of G/C (r=0.493) and VEGF (r=-0.542) is closely related to the severity of portal hypertensive gastric disease in patients with cirrhosis (P<0.05); The area under the diagnostic curve of VEGF for portal hypertensive gastropathy in liver cirrhosis is 0.822, and the optimal diagnostic threshold is 143.45 ng/mL. The area under the diagnostic curve of G/C for portal hypertensive gastropathy with cirrhosis is 0.875, and the optimal diagnostic threshold is 0.87. The area under the curve of the combination of the two is 0.932. The diagnostic sensitivity and specificity of G/C combined with VEGF for portal hypertensive gastric disease in cirrhosis were significantly higher than those of a single indicator (P<0.05). Conclusion: G/C and VEGF are independent influencing factors of portal hypertension in patients with liver cirrhosis, and are significantly correlated with different severity levels. The combination of the two can improve the diagnostic efficacy of portal hypertension in patients with liver cirrhosis. |
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