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目的 探讨胃蛋白酶原(PG)Ⅰ/Ⅱ、胃泌素(G)-17水平对长期服用阿司匹林联合替格瑞洛老年冠心病(CHD)患者并发消化性溃疡出血(PUB)的预测价值。方法 采用病例对照设计，选取双联抗血小板药物治疗后发生PUB的老年CHD患者130例，同期选取未发生PUB的老年CHD患者130例为对照组。检测两组血清PGⅠ、PGⅡ及G-17水平，通过单因素分析筛选基线变量，采用多因素Logistic回归模型探讨PUB发生的危险因素。应用受试者工作特征(ROC)曲线评估PGⅠ/Ⅱ、G-17对PUB的预测效能，并分析PGⅠ/Ⅱ与G-17的交互作用。结果 观察组血清PGⅠ、PGⅡ、PGⅠ/Ⅱ和G-17水平明显高于对照组(P<0.05)。采用向前逐步回归法实施Logistic分析，发现PGⅠ/Ⅱ和G-17为PUB发生的独立危险因素(P<0.05)。建立的回归模型为Y(logit(P))=-0.406+0.669×PGⅠ/Ⅱ+0.512×G-17。基于PUB易感性状态变量分析，PGⅠ/Ⅱ与G-17水平呈现显著正向交互效应。当两指标同时高表达时，其风险值较低表达时提升57.200倍[交互作用相对超危险度比(RERI)=48.351]。协同指数显示，联合效应为单因素效应总和的7.160倍。在联合暴露导致的PUB风险中，交互作用归因比例达84.8%，提示相加交互作用占主导地位。结论 老年CHD患者发生PUB后，血清PGⅠ/Ⅱ和G-17异常上调，是PUB发生、发展的危险因素，二者交互作用可增加PUB发生的风险。
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基本信息:
中图分类号:R541.4;R573.1
引用信息:
[1]梁素妨,刘红军,苏淑红.胃蛋白酶原Ⅰ/Ⅱ、胃泌素17水平对长期服用阿司匹林联合替格瑞洛老年冠心病患者并发消化性溃疡出血的预测价值[J].中国老年学杂志,2026,46(02):204-208.
2026-01-22
2026-01-22