Application Of Salivary Pepsin In Evaluating The Efficacy Of Gastroesophageal Reflux Disease After Peroral Endoscopic Cardial Constriction

Objective: To investigate the value of salivary pepsin in the evalua tion of postoperative efficacy in patients with gastroesophageal reflux di sease(GERD)after peroral endoscopic cardial constriction(PECC).Methods:1.A total of 30 patients with GERD who were treated with PECC in the Department of Gastroenterology of the Second Hospital of Hebei Medical University from January 2020 to January 2021 were collected and studied.According to the presence of esophageal hiatal hernia and atypical symptoms,the patients were divided into two groups:esophageal hiatal hernia group(n=5),non-hiatal hernia group(n=25),typical symptom group(n=18)and atypical symptom group(n=12).2.The patients were treated with PECC by senior endoscopists,and the short-term complications such as bleeding,perforation and infection were observed during and after the operation.3.By comparing the level of salivary pepsin and GERD-Q score b efore and 1 month after operation,we explored the value of salivary pe psin in the evaluation of curative effect of patients with GERD.Results: 1.All the 30 patients were successfully performed PECC,and no fever,bleeding,perforation,dysphagia and other events occurred during and 1 month after operation.2.Before operation,the GERD-Q score of 30 patients was 11.03 ±2.13,and the positive rate was 93.3%(28/30).And the GERD-Q score after operation was 5.47 ±1.61,and the positive rate was 10%(3/30).The quantitative determination of salivary pepsin before operation was 113.65 ±33.12 ng/ml,and the positive rate was 90%(27/30).The quantitative determination of salivary pepsin after operation was 37.05 ±25.27ng/ml,and the positive rate was 13.3%(4/30).The GERD-Q score and the level of salivary pepsin were statistically significant before and after operation.3.In the group with esophageal hiatal hernia,the mean difference of salivary pepsin before and after operation 88.78 ±6.88 ng/ml,while in the group without esophageal hiatal hernia,the mean value of salivary was 75.57 ±33.77ng/ml.There was no significant difference between the two groups.The difference of salivary pepsin before and after operation was 62.14 ±29.34ng/ml in atypical symptom group,and 86.24 ±28.77 ng/ml in typical symptom group.there were significant differences between the two groups.Conclusions:1.PECC is a new method for the treatment of GERD,which has the advantages of good short-term efficacy,safety and feasibility.In comparison,PECC is more effective in patients with only typical symptoms.2.Salivary pepsin is a good tool to evaluate the efficacy of PECC,which can objectively and noninvasively evaluate the postoperative efficacy,but more studies are still needed to further verify its related value.