白介素-6、核周型抗中性粒细胞胞浆抗体与抗酿酒酵母抗体在克罗恩病中的临床价值  

Clinical significance of interleukin-6,perinuclear antineutrophil cytoplasmic antibodies and anti-saccharomyces cerevisiae antibodies in Crohn's disease

作　　者：王志远[1] 李可[1] 庞楠楠[2] 张瑞[2] 

机构地区：[1]新疆医科大学第五附属医院消化内科,新疆乌鲁木齐830000 [2]新疆医科大学第一附属医院血液病中心

出　　处：《胃肠病学和肝病学杂志》2016年第4期452-456,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨白介素-6(IL-6)、核周型抗中性粒细胞胞浆抗体(p ANCA)与抗酿酒酵母抗体(ASCA)在克罗恩病(Crohn’s disease,CD)中的诊断价值。方法共有CD患者67例,健康对照者30名。分别用间接免疫荧光法(IIF)测定p ANCA,酶联免疫吸附法(ELISA)测定IL-6和ASCA,计算各项指标在CD及其亚型中的灵敏度、特异度及阳性预测值,并进行统计学分析。结果 CD活动期患者血清IL-6水平显著高于缓解期及健康对照组,且与病情严重程度呈正相关。p ANCA在CD组与健康对照组中灵敏度差异无统计学意义(P>0.05)。ASCA、ASCA Ig A和ASCA Ig G在两组中阳性率差异均有统计学意义(χ2=16.58、5.69、14.09,P均<0.05),单项检测ASCA Ig A、ASCA Ig G,两种方法间差异无统计学意义(P>0.05)。联合检测IL-6、p ANCA和ASCA可以提高CD诊断的灵敏度、特异度和阳性预测值,对阳性率影响不大。CD各亚型中p ANCA、ASCA灵敏度组间差异均无统计学意义(P>0.05),两种抗体与病情严重程度无明显相关。结论促炎因子IL-6与CD病情进展相关,对CD的诊断和临床评估具有重要意义。ASCA可以作为CD诊断的一个重要血清学指标,而p ANCA对CD的诊断价值相对较小。Objective To evaluate the clinical significance of interleukin-6（IL-6）,perinuclear antineutrophil cytoplasmic antibodies（p ANCA） and anti-saccharomyces cerevisiae antibodies（ASCA） in Crohn＇s disease（ CD）. Methods A total of 67 patients with CD and 30 healthy volunteers as healthy control group were recruited in this study. p ANCA was detected by indirect immunofluorescence assay（IIF）,ASCA and IL-6 were detected by enzyme-linked immunosorbent assay（ELISA）,the sensitivity,specificity and positive predictive value of all CD subtypes were calculated. Results The serum IL-6 in active CD patients was higher than that in remission CD patients and healthy controls（P〈0 05）,the serum IL-6 was positively related with CD severity. The sensitivities of p ANCA had no significant difference between CD group and healthy control group（P〉0 05）. There were significant differences in the sensitivities of ASCA,ASCA Ig A and ASCA Ig G between two groups（χ2= 16. 58,5. 69,14. 09,P〈0 05）. ASCA Ig A or ASCA Ig G detection alone had no significant difference between two methods（P〉0 05）. Combined detection of IL-6,p ANCA with ASCA could improve the sensitivity,specificity and positive predictive value of diagnosis,and cause little impact to positive rate. There was no significant difference in sensitivities of p ANCA and ASCA among the subtype groups of CD（P〈0 05）. Both two antibodies had no clear relativity in the severity of CD. Conclusion The pro-inflammatory cytokines like IL-6 is correlated with CD severity,which is very imperative for diagnosis and clinical appraisal of CD. ASCA is a significant serous antibody for CD and it has certain value for diagnosis,while the diagnostic value of p ANCA is finite.

关 键 词：克罗恩病 白介素-6 抗中性粒细胞胞浆抗体 抗酿酒酵母抗体 

分 类 号：R574.62[医药卫生—消化系统]