摘要
目的 评估粪便钙卫蛋白(FC)对克罗恩病(CD)患者肠切除吻合术后临床与内镜复发的相关性.方法 回顾性纳入2014年7月至2017年4月中山大学附属第六医院炎症性肠病诊疗中心随访的CD肠切除吻合术后患者51例,均通过CD活动指数评估临床活动度,临床复发定义为CD活动指数大于150分;同时进行FC、C反应蛋白(CRP)、红细胞沉降率(ESR)、血小板计数(PLT)检查.39例患者接受了结肠镜检查,内镜复发定义为Rutgeerts评分>1分.结果 术后临床复发与内镜复发的CD患者FC明显高于临床缓解及内镜缓解患者,差异均有统计学意义[1 368(420,3 587)μg/g vs 209(108,1 196)μg/g,P<0.01;1 871(701,3 574)μg/g vs 120(78,267)μg/g,P<0.01].FC与CD活动指数、Rutgeerts评分具有相关性(r=0.52,P<0.01;r=0.74,P<0.01).处于临床缓解期而已发生内镜复发的术后患者的FC浓度显著高于无内镜复发患者,差异有统计学意义[(1 315.42±1 121.28) μg/g vs.(100.92±62.87) μg/g,P<0.01].当FC>142 μg/g时,其诊断术后内镜复发的敏感性为91%,特异性为90%.结论 FC与CD患者术后临床复发及内镜复发均相关,是CD术后内镜复发有价值的无创监测指标.
Objective Monitoring post-operative endoscopic recurrence is essential for initiating an individualized medical therapy in Crohn's disease(CD).The validity of fecal calprotectin in diagnosing post-operative recurrence was evaluated.Methods Fifty-one patients undergoing an intestinal resection and anastomosis were enrolled in this study.Crohn's Disease Activity Index(CDAI)was used to evaluate clinical activity.Fecal calproleclin(FC),C reactive protein(CRP),erythrocyte sedimentation rate(ESR)tested simultaneously.Thirty-three patients had undergone endoscopy.Rutgeerts'score was used to evaluate endoscopic activity.Results The median FC levels of clinical and endoscopic recurrence group were significantly higher than remission group[1368(420,3 587)μg/g vs 209(108,1 196)μg/g,P<0.01;1 871(701,3 574)μg/g vs 120(78,267)μg/g,P<0.01].FC levels were correlate with CDAI and Rutgeerts'score(r=0.52,P<0.01;r=0.74,P<0.01).In patients in clinical remission,FC levels were remarkably higher in endoscopic recurrence group[(1 315.42±1 121.28)μg/g vs(100.92±62.87)μg/g,P<0.01].When FC was higher than 142μg/g,the sensitivity and specificity on diagnosing endoscopic recurrence were 91%and 90%of the in patients in clinical remission.Conclusions FC could be a useful surrogate biomarker to predict post-operative endoscopic recurrence especially in patients in clinical remission.
作者
唐健
胡梦婷
苏明丽
郅敏
高翔
胡品津
Tang Jian;Hu Mengting;Su Mingli;Zhi Min;Gao Xiang;Hu Pinjin(Department of Gastroenterology,the Sixth Affiliated Hospital,Sun Yat-sen University Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)
出处
《中华炎性肠病杂志（中英文）》
2017年第1期41-45,共5页
Chinese Journal of Inflammatory Bowel Diseases
基金
国家自然科学基金(81370498)
天河区科技计划(201404KW018)
广东省科技计划(2011B031800097)
广东省省部产学研结合项目(2012B091100455).
