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Relationship between serum PG, IL-8 and peptic ulcer bleeding associated with NSAIDs in the elderly |
ZHANG Danfeng, YANG Shujie, DA Chenxing, DU Ting, BAI Chuanqi |
Department of Gastroenterology, Shaanxi Provincial Corps Hospital of Chinese People’s Armed Police Force, Xi’an 710054, China |
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Abstract Objective To investigate the relationship between serum pepsinogen (PG), interleukin-8 (IL-8), and non-steroidal anti-inflammatory drugs (NSAIDs) related peptic ulcer bleeding in the elderly. Method A total of 110 elderly patients with NSAIDs related peptic ulcer admitted to Shaanxi Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2022 to December 2023 were selected, and divided into a bleeding group (42 cases) and a non-bleeding group (68 cases) according to whether NSAIDs-associated peptic ulcer occurred in elderly patients. The general data of two groups were collected and the serum levels of gastric protease I (PGⅠ), gastric protease Ⅱ (PG Ⅱ), and IL-8 were detected. The PGR (ratio of PG-ⅰ to PG-ⅱ) was calculated. Logistic regression model was used to analyze the risk factors for peptic ulcer bleeding, and receiver operating characteristic (ROC) curve analysis was used to evaluate the value of serum PG and IL-8 levels for peptic ulcer bleeding. Results There was no significant difference in age, sex, smoking history, drinking history, BMI, hypertension, diabetes, hyperlipidemia, digestive tract disease history, coronary heart disease, anemia, or type of NSAIDs medication between the bleeding group and the non-bleeding group of elderly patients with NSAIDs related peptic ulcer (P>0.05). The history of peptic ulcer, time of taking NSAIDs, PG Ⅱ and IL-8 levels in the bleeding group were higher than those in the non-bleeding group, and the levels of PG Ⅰ and PGR were lower than those in the non-bleeding group (P<0.05); According to the analysis of multiple logistic regression models, history of peptic ulcer (OR=1.193,95%CI:1.120-1.271), time of taking NSAIDs (OR=8.177,95%CI:1.970-33.936), and IL-8 (OR=1.252,95%CI:1.065-1.474)were all independent risk factors for peptic ulcer bleeding in elderly NSAIDs related peptic ulcer patients, and PGR (OR=0.002,95%CI:0.000-0.091) was the protective factor (P<0.05); ROC curve analysis showed that the area under the working characteristic curve (AUC) (95%CI) of PGR and IL-8 alone for predicting peptic ulcer bleeding in subjects was 0.878(0.802-0.933) and 0.832(0.749-0.896), respectively. The log (P) combined prediction AUC (95%CI) was 0.947(0.888-0.981), and the combined prediction performance was better than that of single prediction (P<0.05). Conclusions Serum PGR and IL-8 levels are closely related to peptic ulcer bleeding associated with NSAIDs in elderly patients, and can be used as indicators to evaluate the condition and prognosis of patients.
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Received: 06 August 2024
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