粪便钙卫蛋白与肠镜检查对溃疡性结肠炎诊断及分型的意义分析  

Significance of fecal calprotectin and colonoscopy in diagnosis and classification of ulcerative colitis

作　　者：贾勤 董争华 赵晓明[1] JIA Qin;DONG Zhenghua;ZHAO Xiaoming(Department of Laboratory Medicine,Shanghai East Hospital of Tongji University School of Medicine,Shanghai,200120,China)

机构地区：[1]同济大学附属上海市东方医院南院检验科,上海200120

出　　处：《临床血液学杂志》2023年第6期417-422,共6页Journal of Clinical Hematology

基　　金：上海市公共卫生体系建设三年行动计划(2020—2022年)[No:GWV-10.1-XK04];上海市东方领航人才培养计划(No:DFLH2018003)。

摘　　要：目的:分析探讨粪便钙卫蛋白(fecal calprotectin,FC)及血液检查等实验室指标在溃疡性结肠炎(UC)患者诊断及病情监测中的临床应用价值。方法:收集2020年1月至2022年7月消化内科诊治的UC患者临床资料79例次(61例,有重复病例)作为实验组,选择同期在我院诊断为功能性胃肠功能紊乱的50例患者作为对照组,分析比较实验组与对照组的FC浓度水平。综合临床表现及内镜下所见将UC患者按照病情活动性分为活动组和缓解组,并根据蒙特利尔分型法对UC患者进行疾病分型。分析不同分型和活动性UC患者的FC浓度差异及FC与相关血液指标:白细胞计数(WBC)、C反应蛋白(CRP)、中性粒细胞百分比(NEU%)、血沉(ESR)、降钙素原(PCT)、白细胞介素6(IL-6)、血红蛋白(HGB)、血细胞比容(HCT)的关系,绘制ROC曲线,分析各指标对判断疾病活动性的诊断效能,比较各指标与疾病活动性的相关性。结果:UC患者FC浓度显著高于对照组,差异有统计学意义(P<0.05)。UC活动组FC浓度显著高于缓解组,差异有统计学意义(P<0.05)。不同病变范围的UC患者间FC浓度差异无统计学意义(P>0.05),但随着病变范围扩大,FC浓度有升高趋势。直肠型组、左半结肠型组和全结肠型病变组分型的UC患者活动期FC浓度均高于缓解期,差异无统计学意义。直肠型组UC患者与对照组比较FC浓度差异无统计学意义,但活动期直肠型组UC患者FC浓度与对照组比较差异有统计学意义;左半结肠型组和全结肠型病变组UC患者FC浓度与对照组比较差异有统计学意义。各实验室检查指标中,FC对UC的诊断准确性最高,各血液相关指标对UC的诊断准确性排序为IL-6>CRP>WBC>ESR>NEU%>HCT>HGB>PCT。结论:FC与UC患者内镜下表现和临床严重程度有很好的相关性,其诊断效能高于各血液相关指标,FC在UC患者诊断及病情监测中发挥重要作用,可作为UC患者诊断及治疗的辅助无创性指标。Objective To analyze and discuss the clinical application value of fecal calprotectin(FC)and blood laboratory indexes in the diagnosis and monitoring of ulcerative colitis(UC)patients.Methods The clinical data of 79 UC patients diagnosed and treated in the Department of Gastroenterology of our hospital from January 2020 to July 2022 were retrospectively analyzed as the experimental group,and 50 patients diagnosed with functional gastrointestinal dysfunction in our hospital in the same period were selected as the control group.The FC concentration levels of the experimental group and the control group were analyzed and compared.UC patients were divided into active group and remission group according to their clinical manifestations and endoscopic findings,and they were classified according to Montreal classification method.The difference of FC concentration in UC patients with different types and activities,and the relationship between FC and relevant blood indicators were analyzed,including white blood cell,C-reactive protein(CRP),neutrophil percentage(NEU%),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),interleukin-6(IL-6),hemoglobin(HGB),hematocrit(HCT),ROC curves were drawn,and the diagnostic efficacy of each indicator in judging disease activity were analyzed,and the correlation between each index and disease activity was compared.Results The FC concentration in UC patients was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).FC concentration in UC active group was significantly higher than that in remission group,and the difference was statistically significant(P<0.05).There was no significant difference in FC concentration between UC patients with different lesion ranges(P>0.05),but the FC concentration tended to increase with the expansion of lesion ranges.The FC concentration of UC patients in rectal type group,left hemicolon type group and whole colon type lesion group was higher in active phase than in remission phase,with significant d

关 键 词：粪便钙卫蛋白 溃疡性结肠炎 肠镜检查 活动性 

分 类 号：R516.1[医药卫生—内科学]