2026 年第 2 期 第 21 卷

血清白细胞介素33和白三烯B4联合去整合素-金属蛋白酶17检测对老年慢性萎缩性胃炎的诊断价值

Diagnostic value of combined detection of serum interleukin-33, leukotriene B4 and a disintegrin and metalloproteinase 17 in elderly patients with chronic atrophic gastritis

作者：张宇1陈超锋1龙超1许俊2潘鹏3

英文作者：Zhang Yu1 Chen Chaofeng1 Long Chao1 Xu Jun2 Pan Peng3

单位：1中国人民解放军联勤保障部队第九〇四医院消化内科，常州213000；2上海交通大学医学院附属新华医院崇明分院消化内科，上海200092；3中国人民解放军联勤保障部队第九〇四医院麻醉科，常州213000

英文单位：1Department of Gastroenterology the 904th Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China Changzhou 213000 China; 2Department of Gastroenterology Chongming Hospital Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai 200092 China; 3Department of Anesthesiology the 904th Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China Changzhou 213000 China

关键词：老年慢性萎缩性胃炎；白细胞介素33；白三烯B4；去整合素-金属蛋白酶17

英文关键词：Elderlychronicatrophicgastritis;Interleukin33;LeukotrieneB4;Adisintegrinandmetalloproteinase17

• 摘要：

• 目的 分析血清白细胞介素33（IL-33）、白三烯B4（LTB4）联合去整合素-金属蛋白酶17（ADAM17）检测对老年慢性萎缩性胃炎（CAG）的诊断价值。方法 回顾性选取2022年9月至2024年9月因腹部不适于中国人民解放军联勤保障部队第九〇四医院行胃镜检查的老年患者219例，根据病理活体组织检测结果分为CAG组（122例）和非CAG组（97例）。根据胃黏膜萎缩程度组织学分级将CAG组分为轻度组（36例）、中度组（41例）和重度组（45例）。检测血清IL-33、LTB4、ADAM17水平。Pearson分析CAG患者血清IL-33、LTB4、ADAM17指标之间的相关性。分析血清IL-33、LTB4、ADAM17水平与CAG患者临床病理特征的关系。采用受试者工作特征（ROC）曲线分析血清IL-33、LTB4、ADAM17指标单独及联合检测对老年CAG的诊断价值。结果 CAG组血清IL-33、LTB4、ADAM17水平均高于非CAG组（均P<0.001）。轻度组、中度组、重度组血清IL-33、LTB4、ADAM17水平呈逐步上升趋势（均P＜0.05）。Pearson相关分析结果显示，IL-33与LTB4（r＝0.551，P＜0.001）、IL-33与ADAM17（r＝0.581，P＜0.001）、LTB4与ADAM17（r＝0.443，P＜0.001）均呈正相关。血清IL-33、LTB4、ADAM17表达与CAG患者胃黏膜萎缩、肠化生、慢性炎症及不典型增生均有关（均P<0.05）。ROC曲线分析结果显示，血清IL-33、LTB4、ADAM17单独及三者联合检测诊断CAG的曲线下面积分别为0.868、0.829、0.758、0.908，三者联合的曲线下面积均高于各单项指标的曲线下面积（均P<0.05）。结论 老年CAG患者血清IL-33、LTB4、ADAM17表达随着病情加重而升高，且其联合检测可有效诊断不同病情程度老年CAG患者，为其早期诊断、及时治疗、预防胃黏膜进一步萎缩提供有效指导。

• Objective To analyze the diagnostic value of combined detection of serum interleukin-33 (IL-33), leukotriene B4 (LTB4) and a disintegrin and metalloproteinase 17 (ADAM17) in elderly patients with chronic atrophic gastritis (CAG). Methods A retrospective study was conducted on 219 elderly patients who underwent gastroscopy due to abdominal discomfort at the 904th Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China from September 2022 to September 2024. According to the pathological biopsy results, the patients were divided into CAG group (122 cases) and non-CAG group (97 cases). The CAG group was further subdivided into mild group (36 cases), moderate group (41 cases) and severe group (45 cases) based on the histological grading of gastric mucosal atrophy. Serum levels of IL-33, LTB4 and ADAM17 were detected. Pearson correlation analysis was used to evaluate the correlations between serum IL-33, LTB4 and ADAM17 in CAG patients. The relationships between serum IL-33, LTB4, ADAM17 levels and clinicopathological characteristics of CAG patients were analyzed. Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of single and combined detection of serum IL-33, LTB4 and ADAM17 for elderly CAG. Results Serum levels of IL-33, LTB4, and ADAM17 in the CAG group were significantly higher than those in the non-CAG group (all P<0.001). Serum levels of IL-33, LTB4, and ADAM17 showed a gradual upward trend in the mild, moderate, and severe groups (all P<0.05). Pearson correlation analysis revealed that IL-33 was positively correlated with LTB4 (r=0.551, P<0.001), IL-33 with ADAM17 (r=0.581, P<0.001), and LTB4 with ADAM17 (r=0.443, P<0.001). The expressions of serum IL-33, LTB4, and ADAM17 were associated with gastric mucosal atrophy, intestinal metaplasia, chronic inflammation, and dysplasia in CAG patients (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) for the diagnosis of CAG by single detection of serum IL-33, LTB4, ADAM17, and their combined detection was 0.868, 0.829, 0.758, and 0.908, respectively. The AUC of the combined detection was higher than that of each single indicator (all P<0.05). Conclusion The serum expressions of IL-33, LTB4, and ADAM17 in elderly CAG patients increase with the aggravation of the disease. The combined detection of these three indicators can effectively diagnose elderly CAG patients with different disease severity, providing effective guidance for their early diagnosis, timely treatment, and prevention of further gastric mucosal atrophy.