血清低IgG与溃疡性结肠炎关系研究  

Clinical analysis of the relationship between low serum IgG level and ulcerative colitis

作　　者：王征 郑威扬[1] 李骥[1] 谭蓓[1] 舒慧君[1] 吕红[1] 李玥[1] 钱家鸣[1] 杨红[1] WANG Zheng, ZHENG Wei-yang, LI Ji, TAN Bei, SHU Hui-jun, LYU Hong, LI Yue, QIAN Jia-ming, YANG Hong.(Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, Chin)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院消化内科,北京100730

出　　处：《中国实用内科杂志》2018年第3期227-230,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家卫生计生委公益性行业科研专项(20100-2020);中国医学科学院医学与健康科技创新工程(2016-I2M-3-001);国家自然科学基金(81570505);国家科技部973计划(2015CB943203)

摘　　要：目的探讨血清低免疫球蛋白G(Ig G)与溃疡性结肠炎(UC)的关系。方法 2010年1月至2017年6月期间在北京协和医院住院确诊的73例UC患者被纳入研究,对低Ig G和正常IgG两组患者的临床资料进行回顾性分析。结果 73例UC患者中血清IgG降低的UC患者12例(16.4%)。低Ig G水平的UC患者与IgG水平正常患者相比,超敏C反应蛋白水平显著增高[(47.82±29.89)mg/L对(32.89±36.45)mg/L,P=0.048),重度患者比例明显增高(100%对31.1%,P<0.001)。且低IgG水平UC患者伴发巨细胞病毒(CMV)感染明显增多(61.5%对27.8%,P=0.018)。低IgG水平UC患者较IgG水平正常者激素治疗有效比例显著降低(16.7%对69.8%,P=0.002)。利用受试者工作特征(ROC)曲线分析,IgG水平在6.73 g/L及以上时,预测糖皮质激素治疗有效的敏感度为97.4%,特异度为41.2%。结论血清Ig G可能会成为预测UC患者病情严重程度及激素治疗效果的有价值临床指标。Objective To investigate the relationship between low serum immunoglobulin G （IgG） and ulcerative colitis （UC）. Methods A total of 73 cases of UC in Peking Union Medical College Hospital from January 2010 to June 2017 were enrolled, and the clinical data of patients with low serum IgG and normal serum IgG were comparatively analyzed retrospectively. Results Twelve （16.4%） of 73 patients with UC had low serum IgG. Compared with patients with normal serum IgG, the level of high-sensitivity C-reactive protein （hsCRP） was significantly higher and severe cases were obviously more in those patients with low serum IgG [（47.82±29.89）mg/L vs （32.89＋36.45）mg/L, P=0.048 and 100% vs 31.1%, P〈0.0001]. In terms of concurrent infection, cytomegalovirus（CMV） infection was more frequent in UC patients with low serum IGG（61.5% vs 27.8%, P=0.018）. The effective rate after corticosteroid therapy in low serum IgG group was dramatically lower than that in normal serum IgG group （16.7% vs 69.8%, P=0.002）. The sensitivity and specificity of predicting corticosteroid effectiveness by ROC curve was 97.4% and 41.2% at cut-offvalue of 6.73 g/L for IgG. Conclution Serum IgG level may serve as a promising clinical indicator to predict the disease severity and effectiveness of corticosteroid treatment in the patients with UC.

关 键 词：溃疡性结肠炎 血清IGG 巨细胞病毒 感染 糖皮质激素 

分 类 号：R574[医药卫生—消化系统]