血清IL-6与TNF-α在克罗恩病疾病评估中的应用  

The application value of serum IL-6 and TNF-αin Crohn’s disease

作　　者：陈丹[1] 陈洋[1] 李骥[1] 谭蓓[1] 张鑫垚 张丽[2] 钱家鸣[1] CHEN Dan;CHEN Yang;LI Ji;TAN Bei;ZHANG Xinyao;ZHANG Li;QIAN Jiaming(Department of Gastroenterology,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

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 [2]中国医学科学院北京协和医学院北京协和医院检验科,北京100730

出　　处：《胃肠病学和肝病学杂志》2020年第3期279-284,共6页Chinese Journal of Gastroenterology and Hepatology

基　　金：卫生行业科研专项项目(201002020);中央高校基本科研业务费专项资金资助(3332018012)。

摘　　要：目的探讨克罗恩病(Crohn’s disease,CD)患者血清白介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)水平与克罗恩病疾病活动指数(Crohn’s disease activity index,CDAI)之间的相关性,及以上指标判断疾病活动度或黏膜是否愈合的价值。方法回顾性分析2017年4月至2018年3月北京协和医院收治的CD患者51例,并对患者的临床资料进行分析。结果Pearson相关性分析显示,血清IL-6与CDAI呈正相关(r=0.458,P=0.001)。当设定血清IL-6临界值为7.50 pg/ml(≥7.50 pg/ml),判断疾病活动期的ROC曲线下面积(areas under the ROC curve,AUC)(95%CI)为0.851(0.744~0.985),灵敏性及特异性分别为0.800、0.857(P<0.01)。46例未暴露于英夫利西的CD患者行Pearson相关性分析显示,血清TNF-α与CDAI呈负相关(r=-0.352,P=0.016),血清TNF-α水平在黏膜愈合组显著高于黏膜未愈合组[(68.78±60.10)pg/ml vs(34.66±30.03)pg/ml,P=0.039]。结论CD患者血清IL-6水平与经典炎症指标及疾病活动度呈正相关,是判断CD疾病活动度的良好指标。血清TNF-α水平与疾病活动度呈较弱的负相关。Objective To investigate the correlations of serum interleukin-6(IL-6),tumor necrosis factorα(TNF-α)with Crohn’s disease activity index(CDAI)in Crohn’s disease(CD)and the value of serum markers in determining disease activity or mucosal healing.Methods Fifty-one patients with CD admitted in Peking Union Medical College Hospital from Apr.2017 to Mar.2018 were retrospectively enrolled.Clinical data were collected and analyzed.Results Pearson correlation analysis showed that the level of serum IL-6 was positively correlated with CDAI(r=0.458,P=0.001).ROC curve analysis revealed a cut-off IL-6 level of 7.50 pg/ml(≥7.50 pg/ml)in predicting active disease(CDAI score≥150)with a sensitivity of 0.800,a specificity of 0.857 and the areas under the ROC curve(AUC)of 0.851(95%CI:0.744-0.985)(P<0.01).Within 46 CD patients without exposure to Infliximab,Pearson correlation analysis showed that the level of serum TNF-αwas negatively correlated with CDAI(r=-0.352,P=0.016).The level of serum TNF-αwas higher in patients with mucosal healing than that without reaching mucosal healing[(68.78±60.10)pg/ml vs(34.66±30.03)pg/ml,P=0.039].Conclusion Level of serum IL-6 is positively correlated with classic inflammatory markers and disease activity,and it is a valuable marker to determine the disease activity in CD.Level of serum TNF-αis negatively correlated with disease activity.

关 键 词：白介素6 肿瘤坏死因子α 克罗恩病 疾病活动度 黏膜愈合 

分 类 号：R574.62[医药卫生—消化系统]