胞外游离DNA在炎症性肠病中的作用研究  

The role of cell-free DNA in inflammatory bowel disease

作　　者：王宋杰 张哲 刘霞[1] 王丹丹[1] 刘艳芳[1] 冯百岁[1] Wang Songjie;Zhang Zhe;Liu Xia;Wang Dandan;Liu Yanfang;Feng Baisui(Department of Gastroenterology,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院消化内科,郑州450014

出　　处：《中华炎性肠病杂志（中英文）》2023年第4期331-334,共4页Chinese Journal of Inflammatory Bowel Diseases

基　　金：河南省科技攻关项目(212102310803);河南省医学科技攻关计划联合共建项目(LHGJ20210409、LHGJ20190327、LHGJ20200407)。

摘　　要：目的探讨不同疾病严重程度的炎症性肠病(IBD)患者胞外游离DNA(cfDNA)浓度差异及意义。方法采用横断面研究方法。纳入2021年4月至2022年5月郑州大学第二附属医院收治的91例IBD患者, 包括48例溃疡性结肠炎(UC)患者和43例克罗恩病(CD)患者。另外招募15例健康对照者。比较IBD患者与健康对照组以及不同疾病严重程度IBD患者cfDNA浓度的差异, 同时分析IBD患者cfDNA浓度与实验室检查指标的相关性。结果 IBD患者cfDNA浓度高于健康对照组[(86.7±22.6)ng/ml比(52.6±15.8)ng/ml, P<0.001], UC和CD患者cfDNA浓度均高于健康对照组(均P<0.001), 差异均具有统计学意义。轻度、中度、重度UC患者cfDNA浓度依次更高, 差异均存在统计学意义[(62.9±11.1)ng/ml比(83.6±17.1)ng/ml比(103.9±19.1)ng/ml, 均P<0.01]。UC患者cfDNA浓度与疾病活动度呈正相关(r = 0.74, P<0.001)。活动期CD患者cfDNA浓度高于缓解期[(104.2±17.2)ng/ml比(78.6±18.6)ng/ml, P<0.001], CD患者cfDNA浓度与疾病活动度呈正相关(r = 0.58, P<0.001)。UC患者cfDNA浓度与C-反应蛋白(CRP)(r = 0.4, P<0.01)、红细胞沉降率(ESR)(r = 0.37, P<0.01)水平呈正相关, 与血红蛋白(r = -0.46, P<0.01)、白蛋白(r = -0.51, P<0.01)水平呈负相关。CD患者cfDNA浓度与CRP(r = 0.48, P<0.01)、ESR(r = 0.38, P<0.05)水平呈正相关, 与血红蛋白(r = -0.45, P<0.01)、白蛋白(r = -0.32, P<0.05)水平呈负相关。结论 cfDNA浓度与IBD患者疾病严重程度密切相关, 是评价IBD疾病严重程度的新指标。Objective To investigate the differences in cell-free DNA(cfDNA)concentrations between the inflammatory bowel disease(IBD)patients with different disease severities and the significance.Methods Cross-sectional study was conducted.Ninety-one patients with IBD were included in the Second Affiliated Hospital of Zhengzhou Univesity from April 2021 to May 2022,including 48 patients with ulcerative colitis(UC)and 43 patients with Crohn′s disease(CD).Fifteen healthy people were assigned as healthy control group.The differences in cfDNA concentration between IBD group and healthy control group and between IBD patients with different disease severities were compared.The correlations between cfDNA concentration and laboratory indicators of IBD patients were analyzed.Results The cfDNA concentration of IBD patients was higher than that of healthy control group[(86.7±22.6)ng/ml vs.(52.6±15.8)ng/ml,P<0.001],and the cfDNA concentrations of UC and CD patients were higher than that of healthy control group(both P<0.001),the differences were statistically significant.The cfDNA concentration of mild,moderate and severe UC patients increased successively,and the differences were statistically significant[(62.9±11.1)ng/ml vs.(83.6±17.1)ng/ml vs.(103.9±19.1)ng/ml,all P<0.01].cfDNA concentration of UC patients was positively correlated with disease activity(r=0.74,P<0.001).cfDNA concentration of active CD patients was significantly higher than that in remission stage[(104.2±17.2)ng/ml vs.(78.6±18.6)ng/ml,P<0.001].cfDNA concentration in CD patients was positively correlated with disease activity(r=0.58,P<0.001).cfDNA concentration in UC patients was positively correlated with C-reactive protein(CRP)(r=0.4,P<0.01)and erythrocyte sedimentation rate(ESR)(r=0.37,P<0.01),and negatively correlated with hemoglobin(r=-0.46,P<0.01)and albumin(r=-0.51,P<0.01).cfDNA concentration in CD patients was positively correlated with CRP(r=0.48,P<0.01)and ESR(r=0.38,P<0.05),and negatively correlated with hemoglobin(r=-0.45,P<0.01)and albumin(r=-0.

关 键 词：炎症性肠病 溃疡性结肠炎 克罗恩病 胞外游离DNA 疾病严重程度 

分 类 号：R574[医药卫生—消化系统]