血清IDO和KYN在溃疡性结肠炎中的临床价值研究  

Clinical value of determination of serum IDO and KYN in ulcerative colitis

作　　者：卞秀梅[1] 吴正祥[1] 陶科明[1] 李为慧 

机构地区：[1]安徽医科大学附属省立医院消化内科,合肥230001

出　　处：《安徽医科大学学报》2013年第12期1484-1487,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省卫生厅医学科研基金资助项目(编号:13zc041)

摘　　要：目的检测吲哚胺2,3-双加氧酶(IDO)和犬尿氨酸(KYN)在溃疡性结肠炎(UC)患者中的表达水平,利用受试者工作特征(ROC)曲线分析血清IDO、KYN诊断活动期UC的价值。方法 60例UC组、18例疾病对照组和20例健康对照组。采用免疫组化法检测UC组结肠黏膜中IDO的表达,ELISA法检测3组血清中IDO、KYN和C反应蛋白(CRP)水平,利用ROC曲线进行分析。结果①UC组血清中IDO和KYN水平与结肠黏膜IDO表达量呈正相关(P<0.05);②UC组患者血清IDO及KYN水平高于疾病对照组和健康对照组(P<0.05);③UC组中,活动期患者血清IDO、KYN水平高于缓解期(P<0.01),并随炎症严重程度升高而升高;④活动期UC组IDO、KYN水平与疾病活动度、CRP水平呈正相关;⑤IDO、KYN、CRP的ROC曲线下面积分别为0.976、0.856和0.864;最佳截断值分别为53.66 U/L、2.34 nmol/L和1.75 mg/ml;灵敏度分别为90.5%、78.65%和100.0%;特异度分别为94.4%、83.3%和61.1%;Youden指数分别为0.849 2、0.619 0和0.611 1。结论UC患者血清IDO和KYN水平可以作为判断UC患者炎症程度的重要指标,血清IDO、KYN和CRP水平对活动期UC有重要的诊断价值,其中IDO诊断价值高于KYN和CRP。Objective Detecting the level of IDO and KYN in ulcerative colitis （UC） patients ; using ROC curve to discuss their value in the diagnosis of patients with active UC. Methods 60 cases of UC group, 18 cases of disease control group and 20 cases of healthy control group were included in the study. Immunohistochemical staining methods were used to detect the expression of IDO in colonic mucosa of UC, enzyme-linked immunosorbent （ELISA） methods were used to detect the serum levels of IDO, KYN and CRP, and the value with ROC curve method was analyzed. Results ① There was a positive correlation between IDO level and IDO expression （P 〈 0.05 ）. There was a positive correlation between KYN level and IDO expression （P 〈 0.05 ）. ② The levels of IDO and KYN in UC group were higher than those of disease control group and health control group （ P 〈 0. 05 ）. ③ The levels of IDO and KYN in patients with active UC were significantly higher than that in patients with catabasis UC （P 〈0. 01 ）, and the levels increased with severity of inflammation. ④ The levels of IDO and KYN in active UC were positively related to disease activity and CRP levels （P 〈 0. 05 ）. ⑤ The IDO, KYN and CRP area under ROC curve were 0. 976, 0. 856 and 0. 864 ; best cut-off point were 53.66 U/L, 2. 34 nmol/L and 1.75 mg/ml ; sensitivity were 90.5% , 78.65% and 100. 0% ; specifity were 94.4% , 83.3% and 61.1% ; Youden index were 0. 839 2, 0. 619 0 and 0. 611 1. Conclusion The levels of IDO and KYN in serum can be used as an important index to judge the severity of UC. They have important value in the diagnosis of active UC . The value of IDO is higher than KYN and CRP.

关 键 词：溃疡性结肠炎 吲哚胺2 3-双加氧酶 犬尿氨酸 ROC曲线 

分 类 号：R574.6[医药卫生—消化系统]