摘要
目的探讨粪便钙卫蛋白(fecal calprotectin,FC)在肠易激综合征(irritable bowel syndrome,IBS)和炎症性肠病(inflammatory bowel disease,IBD)鉴别诊断中的意义。方法选择2018年1月~7月江苏省中医院门诊及病房收治的IBS患者38例,IBD患者114例。IBD病例中包含溃疡性结肠炎(ulcerative colitis,UC)63例,克罗恩病(Crohn’s disease,CD)51例。收集同期健康体检者55例作为健康对照。采用酶联免疫吸附试验(ELISA)测定FC水平,并同时检测IBD患者红细胞沉降率(ESR)及C反应蛋白(CRP),分析各组之间FC水平差异,以及FC,ESR和CRP与疾病活动指数的相关性。结果IBD患者FC水平显著高于IBS组及健康对照组,差异有统计学意义(q=15.897,18.523,均P<0.01),UC组FC水平高于CD组,差异有统计学意义(q=5.204,P<0.01);IBS组FC水平和健康组相比,差异无统计学意义(q=0.318,P>0.05)。受试者工作曲线(ROC)分析显示FC升高的临界值为159.5μg/g,对应诊断IBD的最佳灵敏度和特异度分别为91.2%和94.7%。UC组FC,ESR和CRP与Mayo评分均呈正相关性(r=0.851,0.752和0.531,均P<0.01);CD组FC,ESR和CRP与克罗恩病活动指数(CDAI)评分相关系数均呈正相关性(r=0.796,0.693和0.476,均P<0.01)。活动期UC和CD组患者经过治疗后,FC水平显著降低(t=17.543,11.313,均P<0.01)。结论FC可作为鉴别IBS和IBD以及判断IBD活动性和疗效的一个良好指标。
Objective To explore the application value of fecal calprotectin(FC)in differential diagnosis of irritable bowel syndrome(IBS)and inflammatory bowel disease(IBD).Methods From January 2018 to July 2018,38 patients with IBS and 114 patients with IBD in the outpatient and ward clinics of Jiangsu Provincial Hospital of Traditional Chinese Medicine were selected as the research objects.IBD group include 63 cases of ulcerative colitis(UC)and 51 cases of Crohn’s disease(CD).55 healthy people were selected as the healthy controls group.Enzyme-linked immunosorbent assay(ELISA)was used to determine the level of FC,and simultaneously to detect erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)in patients with IBD,and analyzed the differences in FC levels among the groups,as well as FC,ESR,CRP and disease activity index relevance.Results The level of FC in patients with IBD was significantly higher than that in IBS group and healthy control group,and the difference was statistically significant(q=15.897,18.523,all P<0.01),the level of FC in the UC group was higher than that in the CD group,and the difference was statistically significant(q=5.204,P<0.01).There was no significant difference in FC levels between the IBS group and the healthy group(q=0.318,P>0.05).Receiver operator characteristic curve(ROC)showed that the critical value of FC elevation was 159.5μg/g,and the best sensitivity and specificity for the diagnosis of IBD were 91.2%and 94.7%.FC,ESR and CRP in UC group were positively correlated with Mayo score(r=0.851,0.752 and 0.531,all P<0.01).FC,ESR and CRP in CD group were positively correlated with Crohn’s disease activity index(CDAI)score(r=0.796,0.693 and 0.476,all P<0.01).After treatment,patients with active inflammatory bowel disease showed a significant decrease in FC levels(t=17.543,11.313,all P<0.01).Conclusion FC can be used as a good indicator to distinguish IBS and IBD and to judge the activity and efficacy of IBD.
作者
张宪波
刘月皎
陈云峰
ZHANG Xian-bo;LIU Yue-jiao;CHEN Yun-feng(Department of Clinical Laboratory,Jiangsu Provincial Hospital of TCM Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China)
出处
《现代检验医学杂志》
CAS
2021年第1期124-127,共4页
Journal of Modern Laboratory Medicine
关键词
粪便钙卫蛋白
肠易激综合征
炎症性肠病
鉴别
fecal calprotectin
irritable bowel syndrome
inflammatory bowel disease
identification
