粪便钙防卫蛋白对小肠克罗恩病患者疾病活动度和黏膜愈合的预测研究  

Study on fecal calprotectin in predicting disease activity and mucosal healing in patients with small intestinal Crohn′s disease

作　　者：李梦琳 刘浏 廖智英 姚鑫怡 范一宏[2] 黄宣[2] 吕宾[2] 徐毅[2] Li Menglin;Liu Liu;Liao Zhiying;Yao Xinyi;Fan Yihong;Huang Xuan;Lyu Bin;Xu Yi(Department of First Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Gastroenterology,the First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310006,China)

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江中医药大学附属第一医院消化内科,杭州310006

出　　处：《中华消化杂志》2023年第6期388-394,共7页Chinese Journal of Digestion

基　　金：2019年度浙江省中医药科技计划(2019ZA056);2021年度浙江省中医药科技计划(2021ZA057);2022年度浙江省中医药科技计划(2022ZB129);浙江省医药卫生科技计划(2023KY864)。

摘　　要：目的:分析粪便钙防卫蛋白(FC)、C反应蛋白(CRP)、红细胞沉降率(ESR)在结肠与小肠克罗恩病患者中的差异,及其对小肠克罗恩病患者疾病活动度和黏膜愈合的预测价值。方法:选择2017年1月至2023年1月于浙江中医药大学附属第一医院行胶囊内镜检查的克罗恩病患者64例,其中仅存在小肠病变者28例(小肠组),存在小肠和结肠病变或仅累及结肠者36例(回结肠组)。检测并比较两组患者在胶囊内镜检查前15 d内的FC、CRP、ESR水平。统计学方法采用Wilcoxon两样本秩和检验。采用受试者操作特征曲线分析FC、CRP、ESR对小肠克罗恩病患者疾病活动度和黏膜愈合的预测价值。结果:小肠组疾病活动时的FC、CRP、ESR分别为1689.00μg/g(727.75μg/g,1800.00μg/g)、5.67 mg/L(1.00 mg/L,17.01 mg/L)、4.50 mm/1 h(2.00 mm/1 h,11.00 mm/1 h),黏膜愈合时的FC、CRP、ESR分别为112.00μg/g(46.50μg/g,130.50μg/g)、1.00 mg/L(1.00 mg/L,1.62 mg/L)、2.00 mm/1 h(2.00 mm/1 h,5.50 mm/1 h);回结肠组疾病活动时的FC、CRP、ESR分别为1800.00μg/g(895.50μg/g,1800.00μg/g)、4.94 mg/L(3.10 mg/L,14.80 mg/L)、10.00 mm/1 h(2.00 mm/1 h,27.75 mm/1 h),黏膜愈合时的FC、CRP、ESR分别为66.00μg/g(32.50μg/g,97.50μg/g)、1.00 mg/L(1.00 mg/L,1.55 mg/L)、2.00 mm/1 h(2.00 mm/1 h,4.50 mm/1 h)。小肠组与回结肠组疾病活动时和黏膜愈合时的FC、CRP、ESR比较,差异均无统计学意义(均P>0.05)。小肠组中疾病活动患者的FC、CRP分别为1173.00μg/g(312.00μg/g,1800.00μg/g)、2.10 mg/L(1.00 mg/L,16.00 mg/L),均高于黏膜愈合患者的112.00μg/g(46.50μg/g,130.50μg/g)、1.00 mg/L(1.00 mg/L,1.62 mg/L),差异均有统计学意义(Z=-4.35、-2.67,P<0.001、=0.008);小肠组中疾病活动患者的ESR为4.00 mm/1 h(2.00 mm/1 h,16.00 mm/1 h),与黏膜愈合患者的2.00 mm/1 h(2.00 mm/1 h,5.50 mm/1 h)比较,差异无统计学意义(P>0.05)。当FC的截断值为188.50μg/g时,预测小肠克罗恩病患者疾病活动度的灵敏度、特异�Objective To explore the differences of fecal calprotectin(FC),C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)between colon and small intestinal Crohn′s disease,and their predictive values for disease activity and mucosal healing in patients with small intestinal Crohn′s disease.Methods From January 2017 to January 2023,64 patients with Crohn′s disease who underwent capsule endoscopy in the First Affiliated Hospital of Zhejiang Chinese Medical University were enrolled,among them 28 patients had only small intestinal lesions(small intestine group)and 36 patients had lesions involving both small intestine and colon or only colon involvement(ileocolon group).The FC,CRP,and ESR levels of the two groups were detected and compared 15 days before capsule endoscopy examination.Wilcoxon rank-sum test was used for statistical analysis.Receiver operating characteristic curve analysis was used to evaluate the predictive value of FC,CRP,and ESR for disease activity and mucosal healing in patients with small intestinal Crohn′s disease.Results The FC,CRP,and ESR levels of the small intestine group during the active phase of the disease were 1689.00μg/g(727.75μg/g,1800.00μg/g),5.67 mg/L(1.00 mg/L,17.01 mg/L),and 4.50 mm/1 h(2.00 mm/1 h,11.00 mm/1 h),respectively;while FC,CRP,and ESR levels during the mucosal healing phase were 112.00μg/g(46.50μg/g,130.50μg/g),1.00 mg/L(1.00 mg/L,1.62 mg/L),and 2.00 mm/1 h(2.00 mm/1 h,5.50 mm/1 h),respectively.The FC,CRP,and ESR levels of the ileocolon group during the active phase of the disease were 1800.00μg/g(895.50μg/g,1800.00μg/g),4.94 mg/L(3.10 mg/L,14.80 mg/L),and 10.00 mm/1 h(2.00 mm/1 h,27.75 mm/1 h),respectively,while FC,CRP,and ESR levels during the mucosal healing phase were 66.00μg/g(32.50μg/g,97.50μg/g),1.00 mg/L(1.00 mg/L,1.55 mg/L),and 2.00 mm/1 h(2.00 mm/1 h,4.50 mm/1 h),respectively.There were no statistically significant differences in FC,CRP,and ESR between the small intestine group and the ileocolon group during the active phase of the dis

关 键 词：粪便钙卫蛋白 C反应蛋白 红细胞沉降率 克罗恩病 黏膜愈合 

分 类 号：R574.5[医药卫生—消化系统]