血清降钙素原检测在克罗恩病中的临床价值  

Clinical significance of serum procalcitonin in patients with Crohn's disease

作　　者：袁柏思[1] 金鑫鑫[1] 路又可[1] 刘炯[1] 杨妙芳[1] 王震凯[1] 王少东[1] 魏娟[1] 汪芳裕[1] 

机构地区：[1]南京军区南京总医院消化内科,江苏南京210002

出　　处：《胃肠病学和肝病学杂志》2017年第1期48-51,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的研究克罗恩病(Crohn’s disease,CD)患者血清降钙素原(procalcitonin,PCT)水平与病情活动和炎症相关指标的关系。方法检测35例CD患者与15名健康对照者外周血PCT水平,并与炎症相关指标进行相关性分析。结果 CD患者(活动期和缓解期)C-反应蛋白(CRP)、血小板(PLT)计数和白介素-6(IL-6)均明显高于健康对照组,白蛋白(ALB)明显低于健康对照组(P<0.05);活动期CD患者的PCT水平、白细胞(WBC)计数、PLT计数、粪便钙卫蛋白(FC)、IL-6、CRP和血沉(ESR)明显高于缓解期CD,ALB明显低于缓解期CD(P<0.05),而血红蛋白(HB)的差异无统计学意义(P>0.05)。PCT与CDAI、WBC计数、PLT计数、CRP、FC、IL-6呈明显正相关,与ALB、HB水平呈明显负相关(P<0.05),与ESR无明显相关性(P>0.05)。血清PCT水平预测CD活动性优于ESR、CRP、IL-6、WBC、FC、ALB、HB和PLT(P<0.05)。PCT预测CD病情活动ROC曲线的阈值为0.051μg/L,其对应的敏感性为0.879,特异性为0.828,阳性预测值为0.886,阴性预测值为0.75。结论 PCT是一种判断CD病情活动的较好指标,PCT>0.051μg/L作为阈值能够预测大部分活动期CD。Objective To investigate the associations of serum procalcitonin（PCT） level with the disease activity and biological markers of inflammation in Crohn＇s disease（CD）. Methods Correlations of serum PCT level with inflammation-related markers were analyzed in 35 patients with CD and 15 healthy volunteers. Results The PLT count,CRP and IL-6 levels in patients with CD were significantly higher than the control group,but the ALB was significantly lower than the control group（P〈0. 05）. PCT level,WBC count,PLT count,FC,IL-6,CRP and ESR in patients with active CD were significantly higher than that in remission CD,ALB was significantly lower than the remission CD（P〈0. 05）,whereas there was no statistically significant difference of HB between two groups（P〈0. 05）. The serum PCT levels in CD patients were positively correlated with CDAI,WBC count,PLT count,CRP,IL-6 and FC,and were negatively correlated with ALB and HB（P〈0. 05）. However,there was no statistically significant correlation with ESR（P〉0. 05）. PCT performed well in the prediction of CD activity,was superior to ESR,CRP,IL-6,WBC,FC,ALB,HB and PLT（P〈0. 05）. A threshold of 0. 051 μg/L for PCT may predicted the most active CD. And the sensitivity,specificity,predictive positive value and negative predictive value predictive for active CD diagnosis were 0. 879,0. 828,0. 886 and 0. 75,respectively. Conclusion In CD,the serum PCT is a good indicator for prediction disease activity and a cut-off of 0. 051 μg/L could distinguish most active forms of the disease.

关 键 词：克罗恩病 降钙素原 炎症标志物 

分 类 号：R574.62[医药卫生—消化系统]