多维度指标联合对克罗恩病诊治的价值分析  

Value of combined indicators of multi-mensions in diagnosis and treatment of Crohn's disease

作　　者：罗强 罗丽[1] 邓勤勤[1] 李嘉胜 张丹丹[1] 徐宁[1] Luo Qiang;Luo Li;Deng Qinqin;Li Jiasheng;Zhang Dandan;Xu Ning(Medicine Department,Clinical Laboratory,Guangdong Province Hospital of Traditional Chinese Medicine(Second Hospital,Guangzhou University of Traditional Chinese Medicine),Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床学院广东省中医院检验科医学部,广州510370

出　　处：《国际医药卫生导报》2020年第20期3024-3027,共4页International Medicine and Health Guidance News

基　　金：广东省科学技术厅科技计划项目课题(粤科规财字〔2017〕103号编号2017ZC0195)。

摘　　要：目的收集克罗恩病患者的粪便SAA并联合各类炎症和免疫相关指标进行统计分析,探讨包括SAA的多维度联合指标在克罗恩病诊治中的价值。方法收集2016年1月至2018年12月于本院就诊的克罗恩病患者的血清学指标,包括超敏C反应蛋白、白细胞计数、血沉、血红蛋白、IgG、IgM、IgA、C3、C4、CH50、CEA、CA199、胆固醇和粪便常规与潜血、EB-DNA、CMV-DNA指标,同时检测确诊为克罗恩病患者的粪便SAA,作为试验组(CD组)。收集确诊为溃疡性结肠炎患者(UC组)和排除消化道疾病的健康人(NC组)相同的血清学指标作为对照。运用非参数秩和检验、卡方检验和二元logistic回归进行统计学分析。结果CD组和UC组比较,胆固醇和EB-DNA差异有统计学意义,其余各项指标差异均无统计学意义。CD组和NC组比较,WBC、hs-CRP、血沉差异均具有统计学意义,其余各项指标差异均无统计学意义。SAA联合其他炎症标进行二元logistic回归分析各项指标差异均无统计学意义。结论粪便SAA水平不是克罗恩病诊治的有效指标。多维度指标中联合WBC、hs-CRP、血沉、胆固醇、EB-DNA可用于克罗恩病和溃疡性结肠炎之间的辅助诊断和辅助鉴别诊断。Objective To explore the value of combined indicators of multi-mensions,including SAA,in diagnosis and treatment of Crohn's disease collecting and analyzing inflammatory and immune indicators and SAA in feces in patients with Crohn's disease.Methods The serological and immune indicators,including hypersensitivity C reactive protein,leukocyte count,erythrocyte sedimentation rate,hemoglobin,immunoglobulin G,immunoglobulin M,immunoglobulin A,complement 3,complement 4,rat 50%complement hemolysis,carcino-embryonic antigen,carbohydrate antigen 199,cholesterol,fecal routine and occult blood test,EB-DNA,CMV-DNA,and SAA were collected from the patients with Crohn's disease treated at our hospital from January,2016 to April,2018;the patients were set as a CD group.The same serological and immune indicators of the patients with ulcerative colitis(a UC group)and those without digestive tract diseases(a NC group)were collected as controls.These data were analyzed by nonparametric rank sum test,chi-square test,and two element logistic regression analysis.Results There were statistical differences in cholesterol and EB-DNA but not in the other indicators between the CD group and the UC group.There were statistical differences in WBC,hypersensitive C reactive protein,and erythrocyte sedimentation but not in the other indicators between the CD group and the NC group.Two element logistic regression analysis showed that there were no statistical differences between SAA and other indicators.Conclusion Fecal SAA level is not an effective indicator for diagnosis and treatment of Crohn's disease.Multi-dimensions indicators,including hypersensitivity C reactive protein,leukocyte count,erythrocyte sedimentation rate,cholesterol,and EB-DNA,should be effective for diagnosis and differential diagnosis of Crohn's disease and ulcerative colitis.

关 键 词：多维度 SAA 克罗恩病 诊治 

分 类 号：R574.62[医药卫生—消化系统]