血清基质Gla蛋白与溃疡性结肠炎患者黏膜炎症程度的关系及对中毒性巨结肠的预测研究  

Study on the relationship between serum matrix Gla protein and mucosal inflammation in patients with ulcerative colitis and the prediction of toxic megacolon

作　　者：王蒲春 刘德志 范新 Wang Puchun;Liu Dezhi;Fan Xin(Department of Emergency,3201 Hospital Affiliated to Xi'an Jiaotong University,Hanzhong,Shaanxi 723000,China)

机构地区：[1]西安交通大学附属三二〇一医院急诊科,陕西省汉中市723000

出　　处：《北京医学》2021年第12期1188-1191,共4页Beijing Medical Journal

摘　　要：目的分析血清基质Gla蛋白(matrix Gla protein,MGP)与溃疡性结肠炎患者黏膜炎症程度的关系及对中毒性巨结肠的预测价值。方法选择2015年1月至2018年1月西安交通大学附属三二〇一医院收治的162例溃疡性结肠炎患者,根据Mayo内镜评分评价黏膜炎症程度,分为轻度组、中度组和重度组,比较3组PLT、平均血小板体积(mean platelet volume,MPV)、ESR、CRP和MGP水平,采用Pearson相关性分析探讨血清MGP水平与Mayo内镜评分的关系。随访36个月,观察中毒性巨结肠的发生情况,采用ROC曲线下面积(AUC)评价血清MGP对中毒性巨结肠的预测效能。结果轻度组(91例)PLT、ESR、CRP和MGP水平分别为(189.41±28.76)×10^(9)/L、22.19(15.75,28.74)mm/h、10.10(5.12,15.42)mg/L和11.12(6.12,16.25)nmol/L,中度组(39例)分别为(273.16±46.92)×10^(9)/L、38.45(28.75,45.75)mm/h、18.41(10.74,27.56)mg/L和20.35(15.41,27.15)nmol/L,重度组(32例)分别为(365.42±69.47)×10^(9)/L、62.30(47.10,75.45)mm/h、63.21(39.85,85.41)mg/L和29.47(20.12,32.15)nmol/L;重度组PLT、ESR、CRP和MGP水平明显高于轻度组和中度组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,溃疡性结肠炎患者ESR(r=0.233,P=0.042)、CRP(r=0.221,P=0.045)和MGP(r=0.315,P<0.001)水平与Mayo内镜评分呈正相关(P<0.05);溃疡性结肠炎患者ESR(r=0.254,P=0.036)、CRP(r=0.267,P=0.033)水平与MGP水平呈正相关(P<0.05);多因素logistic回归分析显示,ESR、CRP和MGP是中毒性巨结肠的独立预测因素(P<0.05);ROC分析显示,血清MGP预测溃疡性结肠炎患者发生中毒性巨结肠的AUC为0.896,大于ESR的0.654和CRP的0.638,差异有统计学意义(Z=2.158、2.634,P均<0.001)。结论血清MGP水平与溃疡性结肠炎患者黏膜炎症程度呈正相关,其预测中毒性巨结肠发生的效能较好,值得临床重视。Objective To analyze the relationship between serum matrix Gla protein(MGP)and mucosal inflammation in patients with ulcerative colitis and its predictive value for toxic megacolon.Methods A total of 162 patients with ulcerative colitis admitted to 3201 Hospital Affiliated to Xi’an Jiaotong University from January 2015 to January 2018 were selected as the study subjects.The degree of mucosal inflammation was evaluated according to Mayo endoscopic score,and the patients were accordingly divided into mild group,moderate group and severe group.The PLT,mean platelet volume(MPV),ESR,CRP and MGP levels of the three groups were compared.Pearson correlation was used to analyze the relationship between serum MGP level and Mayo endoscopic score.The patients were followed up for 36 months to observe the occurrence of toxic megacolon,and the area under ROC curve(AUC)was used to evaluate the predictive efficacy of serum MGP for toxic megacolon.Results The levels of PLT,ESR,CRP and MGP in mild group(91 cases)were(189.41±28.76)×10^(9)/L,22.19(15.75,28.74)mm/h,10.10(5.12,15.42)mg/L,11.12(6.12,16.25)nmol/L,respectively.The levels of PLT,ESR,CRP and MBP in moderate group(39 cases)were(273.16±46.92)×10^(9)/L,38.45(28.75,45.75)mm/h,18.41(10.74,27.56)mg/L,20.35(15.41,27.15)nmol/L,respectively.The levels of PLT,ESR,CRP and MGP in severe group(32 cases)were(365.42±69.47)×10^(9)/L,62.30(47.10,75.45)mm/h,63.21(39.85,85.41)mg/L,29.47(20.12,32.15)nmol/L,respectively.The levels of PLT,ESR,CRP and MGP in the severe group were significantly higher than those in the mild group and moderate group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that ESR(r=0.233,P=0.042),CRP(r=0.221,P=0.045)and MGP(r=0.315,P<0.001)levels of patients with ulcerative colitis were positively correlated with Mayo endoscopy score(P<0.05).The levels of ESR(r=0.254,P=0.036)and CRP(r=0.267,P=0.033)were positively correlated with MGP(P<0.05)in patients with ulcerative colitis.Multivariate logistic regression analysis show

关 键 词：溃疡性结肠炎 黏膜炎症 基质GLA蛋白 中毒性巨结肠 预测 

分 类 号：R574.62[医药卫生—消化系统]