To explore the diagnostic value of ultrasound combined with serum gastrin 17 (G-17) and pepsin for gastroesophageal reflux diseases (GERD).

A retrospective analysis was conducted on the clinical data of 402 patients with GERD admitted to Yan'an University Affiliated Hospital from March 2022 to March 2024, they were included in the observation group, and another 130 healthy individuals who underwent physical examinations during the same period were selected as the control group. According to the 24-hour esophageal pH monitoring examination results of the patients in the observation group, they were divided into the non-erosive reflux disease group (n=228) and the reflux esophagitis group (n=174), all subjects underwent ultrasound examination, and the ultrasound examination parameters [gastric cardia (His) angle, abdominal esophageal length] and the levels of indicators such as serum G-17 and pepsin of all subjects were collected; the differences of each index among subjects in different groups were compared; the receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to evaluate the diagnostic value of multiple ultrasound parameters combined with G-17 and pepsin for gastroesophageal reflux diseases.

The His angle in the reflux esophagitis group was larger than that in the non-erosive reflux disease group and the control group, the His angle in the non-erosive reflux disease group was larger than that in the control group, the length of the abdominal esophagus in the reflux esophagitis group was shorter than that in the non-erosive reflux disease group and the control group, the length of the abdominal esophagus in the non-erosive reflux disease group was shorter than that in the control group, with statistically significant differences (P<0.05). The levels of G-17 and pepsin in the reflux esophagitis group were higher than those in the non-erosive reflux disease group and the control group, the non-erosive reflux disease group was higher than the control group, with statistically significant differences (P<0.05). The AUC of His angle, abdominal esophageal length, G-17 and pepsin in the diagnosis of gastroesophageal reflux disease was 0.602, 0.590, 0.581 and 0.567 respectively, all of which had diagnostic value for gastroesophageal reflux disease (P<0.05). The cutoff was calculated based on the Youden index principle, the His angle, abdominal esophageal length, G-17, and pepsin were 95.32°, 2.50 cm, 5.56 pmol/L, and 25.50 ng/ml, respectively, among them, the combined diagnostic value was the best, and the corresponding sensitivity and specificity were 76.3% and 84.6%, respectively. The results of univariate and multivariate Logistic regression analyses showed that His angle<95.32°, abdominal esophageal length≥2.50 cm, G-17<5.56 pmol/L, and pepsin<25.50 ng/ml were protective factors for gastroesophageal reflux disease (P<0.05).

Ultrasound detection of the His angle and the length of the abdominal esophagus combined with serum G-17 and pepsin can improve the detection rate of gastroesophageal reflux disease to a certain extent, the combination of multiple indicators provides a more reliable reference basis for the diagnosis and prognosis evaluation of clinical patients.