粪便钙卫蛋白在克罗恩病活动度判断中的诊断效能  

Diagnostic efficacy of fecal calprotectin on assessing crohn′s disease activity

作　　者：陈金敏[1] 郑浩轩[2] 徐智民[2] 刘涛[2] 邓飞鸿 王道蓉[1] 

机构地区：[1]湖北文理学院附属襄阳市中心医院消化内科,441000 [2]南方医科大学南方医院消化内科,广州510515

出　　处：《重庆医学》2016年第2期209-211,215,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81472320)

摘　　要：目的研究粪便钙卫蛋白（FC）在结肠或回结肠型克罗恩病（CD）及CD术后患者内镜下活动度判断中的诊断效能。方法选取已确诊结肠或回结肠型CD患者56例、CD术后患者25倒及肠易激综合征（IBS）患者25例。均于结肠镜检查前1～3d内留取粪便，采用ELISA方法测定FC的水平。结肠或回结肠型CD及CD术后患者内镜活动度评估分剐采用简单克罗恩病内镜评分（SES-CD）和Rutgeerts’评分。结果在结肠或回结肠型CD患者中，活动期FC水平明显高于缓解期和IBS组（P〈0．01），FC水平与SES-CD评分呈正相关（r=0．802，P〈0.01），FC在临界值250μg／g时预测内镜活动度的灵敏度和特异度分别为97．1％和71．4％。在CD术后患者中，活动期及缓解期FC水平均明显高于IBS组（P〈0.01），但活动期FC水平与缓解期相比差异无统计学意义（P〉0.05），FC在临界值250μg／g时预测内镜疾病复发的灵敏度和特异度分别为50．0％和66．7％。结论FC能准确地反映结肠或回结肠型CD患者内镜疾病的活动度，但FC不能区别CD术后患者疾病的缓解期和活动期。Objective To investigate the diagnostic efficacy of fecal calprotectin（FC） on assessing endoscopic disease activity in colonic or ileo-colonic Crohn disease （CD） and CD-related surgery patients. Methods Totally 56 colonic or ileo-eolonie CD patients, 25 CD-related surgery patients and 25 irritable bowel syndrome （IBS） patients with previously confirmed diagnosis of CD and IBS were enrolled into this study. Fecal samples were collected from 1 to 3 clay before bowel preparation and FC was measured by ELISA. Endoscopic activity was determined for colonic or ileo-eolonic CD with Simple Endoscopic Score for Crohnts Disease （SES- CD） and CD-related surgery patients with the Rutgeerts＇ score. Results Among colonic or ileo-colonic CD patients, the levels of FC in endoscopic active patients had significantly higher than that of endoscopic remission patients and IBS patients（P〈0. 01）, there was significant correlation between levels of FC and the SES-CD （r=0. 802 ,P〈0.01）. FC threshold of 250μg/g was tested to indicated active endoscopic disease with 97.1% sensitivity and 71.4% specificity. Among CD-related surgery patients,FC level in IBS patients were significantly lower than that of endoscopic remission patients and endoscopic active patients, but the FC in endoscopie remission patients and endoscopic active patients had no statistic difference（P〈0.05）, FC cutoff level of 250 μg/g gave a sensitivity and specificity of 50.0 %, 66.7 %, respectively. Conclusion FC is a surrogate marker for the evaluation of colonic or iteo-colonic CD endoscopic disease activity. The FC, however, can not distinct remission period and active period after CD surgery.

关 键 词：钙卫蛋白 CROHN病 内窥镜检查 

分 类 号：R574.62[医药卫生—消化系统]