不同胶囊内镜评分指数评估克罗恩病活动程度的相关性分析  

Correlation between different scoring indexes of capsule endoscopy and disease activity in Crohn＇s disease

作　　者：沈玲燕[1] 杜娟[1] 张冰凌[1] 陈春晓[1] 

机构地区：[1]浙江大学医学院附属第一医院消化科,杭州310003

出　　处：《中华消化杂志》2015年第10期654-658,共5页Chinese Journal of Digestion

摘　　要：目的探讨胶囊内镜克罗恩病活动指数（CEcDAI）评分、胶囊内镜评分指数（Lewis评分）、简化CD活动指数（简化CDAI）评分、血清CRP及ESR评估CD的病变活动程度的相关性。方法收集2009年4月至2014年4月行胶囊内镜检查并最终确诊为CD的患者120例，记录其血清CRP和ESR值。分别用CECDAI评分、Lewis评分、简化CDAI评分对患者CD病情活动程度进行评分。应用Spearman检验分析评估CECDAI评分、Lewis评分、简化CDAI评分、血清CRP水平及ESR水平间的相关性。结果在全部患者中，CECDAI评分与Lewis评分有良好的相关性（r=0．645，P〈0．01），与简化CDAI评分亦相关（r=0．190，P〈0．05），与CRP、ESR有良好的相关性（r=0．315、0．393，P均〈0．01）；但Lewis评分与简化CDAI评分、CRP及ESR无明显相关（r=0．052、0．041、0．021，P均〉0．05）；CRP、ESR与简化CDAI评分有较好的相关性（r=0．438、0．429，P均〈0.01）。在胶囊内镜未通过小肠的患者中，CECDAI评分与简化CDAI评分、CRP及ESR均无明显相关性（r=0．126、0．181、0．269，P均〉0.05）。结论Lewis评分、简化CDAI评分、CRP和ESR均在能一定程度上反映CD患者的病情活动程度，CECDAI评分是评估CD患者病情活动程度的最适合指标，需重视胶囊内镜的检查。Objective To investigate the correlation between capsule endoscopy Crohn% disease activity index （CECDAI）, capsule endoscopy Lewis score, simplified Crohn＇s disease activity index （sCDAI）, C reactive protein （CRP）, erythrocyte sedimentation rate （ESR） and Crohn＇s disease （CD） activity. Methods From April 2009 to April 2014, 120 patients having received capsule endoscopy examination and diagnosed as CD were collected. The data of CRP and ESR were analyzed. The CD severity was scored by CECDAI, Lewis score and sCDAI. Spearman correlation was performed to analyze the correlation between CECDAI, Lewis score, sCDAI, CRP and ESR. Results Among all the patients, CECDAI had a good correlation with Lewis score （r= 0. 645, P〈0. 01） and also was correlated with sCDAI （r=0. 190, P〈0.05）, CRP and ESR （r=0.315 and 0.393, both P〈0.01）. However, the Lewis score was not correlated with sCDAI, CRP and ESR （r=0. 052,0. 041 and 0. 021, all P〉0.05）. sCDAI had a good correlation with CRP and ESR （r=0. 438 and 0. 429, both P〈0.01）. Among patients whose capsule endoscope failed to pass through the whole small intestinal, the CECDAI had no significant correlation with sCDAI, CRP and ESR （r=0. 126, 0. 181 and 0. 269, all P〉0.05）. Conclusions Lewis score, sCDAI, CRP and ESR can reflect disease activity of CD patients in a certain degree. CECDAI is the most suitable index in evaluating the disease activity of CD patients. Therefore, it is necessary to attach importance to capsule endoscopy examination.

关 键 词：CROHN病 胶囊内镜克罗恩病活动指数评分 胶囊内镜评分指数 简化克罗恩病活动指数 C反应蛋白 

分 类 号：R574.62[医药卫生—消化系统]