Ye L C, Bu X L, Dai S X, Zheng Z W, Shen A P, Lu M F, Guo Y L, Huang J H, Wang D L, Chen X E, Zhang H J, Sha W H
Second Clinical Medical College, Southern Medical University, Guangzhou 510515, China.
Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
Zhonghua Yi Xue Za Zhi. 2020 May 12;100(18):1414-1418. doi: 10.3760/cma.j.cn112137-20191111-02454.
To identify the value of the detection of pepsin and bile acids in saliva for the diagnosis of gastroesophageal reflux disease(GERD). From January 2018 to June 2019, 104 GERD patients and 43 healthy people in Guangdong Provincial People's Hospital were recruited. The 104 patients of GERD group were divided into four sub-groups, including esophageal symptoms GERD group, extraesophageal symptoms GERD group, anxiety or depression group, non-anxiety and non-depression group. Saliva was collected on waking in morning and 2 h after finishing lunch. The concentration of the total pepsin(TPP) and total bile acids(TBA) from saliva was detected by ELISA method. Receiver operating characteristics analysis was used to identify the sensitivity and specificity of the saliva pepsin and bile acids detection. The concentration of TPP in morning waking samples and postprandial samples in the GERD group was 27.1(9.7,50.3) μg/L and 32.4(14.0,58.7) μg/L, the concentration of TBA in postprandial samples was (18.4±2.3)μmol/L, and these levels were significantly higher than that of the control group 7.0(5.1, 9.1) μg/L, 7.4(5.2, 9.4) μg/L, (12.6±5.0)μmol/L. The concentration of TBA in morning waking samples had no significant difference between these two groups(0.05). The concentration of TPP and TBA had no significant difference among the four GERD sub-groups(0.05).Pepsin in postprandial saliva samples had moderate diagnostic value for GERD, when the saliva pepsin concentration in postprandial samples was higher than 41.33 μg/L, it had a sensitivity of 82.8% and a specificity of 73.3%. The bile acids in saliva had no significant diagnostic value for GERD. Pepsin detection in saliva has a high level of sensitivity and specificity for diagnosing GERD. However, bile acids in saliva has no significant diagnostic value for GERD.
探讨唾液中胃蛋白酶和胆汁酸检测对胃食管反流病(GERD)诊断的价值。选取2018年1月至2019年6月广东省人民医院收治的104例GERD患者和43例健康人。将104例GERD患者分为食管症状GERD组、食管外症状GERD组、焦虑或抑郁组、非焦虑非抑郁组4个亚组。于晨起及午餐结束后2 h采集唾液,采用酶联免疫吸附测定(ELISA)法检测唾液中总胃蛋白酶(TPP)和总胆汁酸(TBA)浓度,应用受试者工作特征(ROC)分析确定唾液胃蛋白酶和胆汁酸检测的敏感度和特异度。GERD组晨起及餐后唾液TPP浓度分别为27.1(9.7,50.3)μg/L和32.4(14.0,58.7)μg/L,餐后唾液TBA浓度为(18.4±2.3)μmol/L,均显著高于对照组[7.0(5.1,9.1)μg/L、7.4(5.2,9.4)μg/L、(12.6±5.0)μmol/L](P<0.01)。两组晨起唾液TBA浓度差异无统计学意义(P>0.05)。4个GERD亚组间TPP和TBA浓度差异无统计学意义(P>0.05)。餐后唾液胃蛋白酶对GERD有中度诊断价值,餐后唾液胃蛋白酶浓度>41.33 μg/L时,敏感度为82.8%,特异度为73.3%。唾液胆汁酸对GERD无显著诊断价值。唾液胃蛋白酶检测对GERD诊断具有较高的敏感度和特异度,而唾液胆汁酸对GERD无显著诊断价值。