Pan Jiachao, Zhang Bo, Ren Wenqiang
Department of Gastroenterology, Central Hospital Affiliated to Shandong First Medical University, No. 105 Jiefang Road, Lixia District, Jinan City, Shandong Province, 250013, China.
Department of Internal Medicine Second Ward, Jinan Hospital, Jinan, 250013, China.
BMC Gastroenterol. 2025 May 28;25(1):413. doi: 10.1186/s12876-025-04024-5.
This study aimed to explore the feasibility of constructing compound digestive enzyme therapeutic effect prediction model based on serum pepsinogen I (PGI), pepsinogen II (PGII), vasoactive intestinal peptide (VIP), and peroxidase 1 (PRDX1) in patients with functional dyspepsia (FD), and draw nomograms, to provide reference for the selection of clinical treatment.
A total of 249 FD patients who visited the Department of Gastroenterology in our hospital from January 2021 to December 2024 were selected, and the preoperative clinical and laboratory indicators were collected. the patient cohort was split in a 7:3 ratio into a training set (n = 174) and a validation set (n = 75). The risk factors were screened by univariate and multivariate logistic regression in the training set, and the nomogram model was constructed. The receiver operating characteristic curve (ROC) was drawn and the calibration curve was used to evaluate the effectiveness of the model. The model was verified in the verification set, and the clinical value was evaluated by decision curve analysis (DCA).
The results of multivariate logistic regression showed that PGI, PGII, VIP, PRDX1, white blood cell count, aspartate aminotransferase and high density lipoprotein cholesterol were the independent risk factors for poor efficacy of compound digestive enzymes in the treatment of FD. The C-index was 0.830 and 0.827, respectively, the area under the ROC curve (AUC) was 0.835 (95% CI: 0.792-0.941) and 0.835 (95% CI: 0.687-0.983), and the sensitivity and specificity were 0.768, 0.857, and 0.778, 0.780, respectively.
The therapeutic effect prediction model of compound digestive enzyme base on serum PGI, PGII, VIP, PRDX1 in patients with FD has some clinical value, but it still need to be further verified by large sample size and multi-center study.
本研究旨在探讨基于血清胃蛋白酶原I（PGI）、胃蛋白酶原II（PGII）、血管活性肠肽（VIP）和过氧化物酶1（PRDX1）构建功能性消化不良（FD）患者复合消化酶治疗效果预测模型并绘制列线图，为临床治疗方案的选择提供参考。
选取2021年1月至2024年12月在我院消化内科就诊的249例FD患者，收集术前临床及实验室指标。将患者队列按7:3比例分为训练集（n = 174）和验证集（n = 75）。在训练集中通过单因素和多因素逻辑回归筛选危险因素，构建列线图模型。绘制受试者工作特征曲线（ROC），并使用校准曲线评估模型的有效性。在验证集中对模型进行验证，并通过决策曲线分析（DCA）评估其临床价值。
多因素逻辑回归结果显示，PGI、PGII、VIP、PRDX1、白细胞计数、天冬氨酸转氨酶和高密度脂蛋白胆固醇是复合消化酶治疗FD疗效不佳的独立危险因素。C指数分别为0.830和0.827，ROC曲线下面积（AUC）分别为0.835（95%CI：0.792 - 0.941）和0.835（95%CI：0.687 - 0.983），灵敏度和特异度分别为0.768、0.857和0.778、0.780。
基于血清PGI、PGII、VIP、PRDX1构建的FD患者复合消化酶治疗效果预测模型具有一定临床价值，但仍需大样本、多中心研究进一步验证。
