炎症性肠病患者血清胆红素水平分析  

Analysis of serum bilirubin levels in patients with inflammatory bowel disease

作　　者：吴世东 邓金鹏 丁康[2] 宋佳希 WU Shidong;DENG Jinpeng;DING Kang;SONG Jiaxi(Department of Laboratory Medicine,2.Department of Colorectal Surgery,Nanjing Hospital of Chinese Medicine/Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210001,Jiangsu,China)

机构地区：[1]南京市中医院,南京中医药大学附属南京中医院检验科,南京210001 [2]南京市中医院,南京中医药大学附属南京中医院肛肠科,南京210001

出　　处：《医学研究与战创伤救治》2023年第11期1154-1159,共6页Journal of Medical Research & Combat Trauma Care

基　　金：江苏省自然科学基金(BK20221178)。

摘　　要：目的 分析炎症性肠病(IBD)患者血清胆红素(sTB)水平,探讨其与患者病情的关系。方法 选取2019年1月-2020年9月在南京市中医院就医并确诊的IBD患者165例,其中克罗恩病患者80例(CD组)、溃疡性结肠炎患者85例(UC组),收集同期体检健康者163例作为健康人对照组。检测IBD患者sTB、红细胞沉降率(ESR)、C反应蛋白(CRP)和血红蛋白(Hb)水平,分析IBD患者血清sTB水平的变化,及其在患者不同病变范围中的水平差异,探讨sTB与IBD患者疾病活动性的严重程度(UC患者改良Mayo评分、CD患者简化CDAI评分)、ESR、CRP和Hb的相关性。结果 与对照组血清sTB[(12.99±2.71)μmol/L]相比,CD组[(9.48±3.29)μmol/L]和UC组[(10.14±5.11)μmol/L]患者血清sTB的水平均显著降低(P<0.001),CD组和UC组患者血清sTB的水平比较差异无统计学意义(P>0.05)。UC患者中,不同病变范围患者,即直肠病变组(E1)[9.90 (7.30,13.70)μmol/L]、左半结肠病变组(E2)[10.70 (6.70,15.90)μmol/L]和广泛结肠组(E3)[6.80 (5.10,11.70)μmol/L]血清sTB水平差异有统计学意义(H=7.793,P=0.020)。相关性分析结果显示,UC患者sTB与改良Mayo评分(r=-0.359,P=0.001)、CRP(r=-0.496,P<0.001)和ESR(r=-0.483,P<0.001)水平呈负相关,与Hb水平呈正相关(r=0.534,P<0.001)。CD患者sTB与简化CDAI评分呈负相关(r=-0.578,P<0.001),与Hb水平呈正相关(r=0.375,P<0.001),与CRP和ESR水平无相关性(P>0.05)。结论 IBD患者的sTB水平降低,分析IBD患者sTB的水平有助于评估患者疾病活动程度,可为判断UC病变范围提供新的参考指标。Objective To analyze the level of serum total bilirubin(sTB)in patients with inflammatory bowel disease(IBD)and explore the relationship between sTB and the disease condition.Methods A total of 165 patients with IBD diagnosed in Nanjing Hospital of Chinese Medicine from January 2019 to September 2020 were selected,including 80 patients with Crohn′s disease(CD group)and 85 patients with ulcerative colitis(UC group),and 163 healthy subjects were collected as control group.The levels of sTB,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and hemoglobin(Hb)in IBD patients were detected,and the changes of sTB levels in IBD patients and their differences in different pathological ranges were analyzed.To investigate the association of sTB with the severity of disease activity(modified Mayo score in UC patients,simplified CDAI score in CD patients),ESR,CRP,and Hb in IBD patients.Results Compared with the control group,the sTB levels in CD group[(9.48±3.29)μmol/L]and UC group[(10.14±5.11)μmol/L]were significantly decreased(P<0.001).There was no significant difference in sTB level between CD group and UC group(P>0.05).In UC patients,there was a statistically significant difference in sTB levels among patients with different lesion ranges(H=7.793,P=0.020),namely rectal lesion group(E1)[9.90(7.30,13.70)μmol/L],left half colon lesion group(E2)[10.70(6.70,15.90)μmol/L]and extensive colon group(E3)[6.80(5.10,11.70)].Correlation analysis results showed that sTB in UC patients was negatively correlated with improved Mayo score(r=-0.359,P=0.001),CRP(r=-0.496,P<0.001)and ESR(r=-0.483,P<0.001),and positively correlated with Hb level(r=0.534,P<0.001).In CD patients,sTB was negatively correlated with simplified CDAI score(r=-0.578,P<0.001),pos-itively correlated with Hb level(r=0.375,P<0.001),and had no correlation with CRP and ESR level(P>0.05).Conclusion The sTB level of IBD patients is decreased,and the analysis of sTB level of IBD patients is helpful to evaluate the degree of disease ac-tivity of patients,and ca

关 键 词：炎症性肠病 克罗恩病 溃疡性结肠炎 血清胆红素 改良Mayo评分 简化CDAI评分 

分 类 号：R574[医药卫生—消化系统]