小肠CT造影联合粪便钙卫蛋白评估克罗恩病活动性的应用价值  

Application of CT enterography combined with fecal calprotectin in evaluating the activity of Crohn disease

作　　者：成维艳 孙其安 肖炜明 薛贞龙 CHENG Weiyan;SUN Qi′an;XIAO Weiming;XUE Zhenlong(Department of Radiology,the Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu 225000,China;Department of Gastroenterology,the Affiliated Hospital of Yangzhou University)

机构地区：[1]扬州大学附属医院放射科,江苏扬州225000 [2]扬州大学附属医院消化内科

出　　处：《徐州医科大学学报》2024年第11期815-820,共6页Journal of Xuzhou Medical University

基　　金：国家自然科学基金面上项目(81873866)。

摘　　要：目的探讨小肠CT造影(CTE)、粪便钙卫蛋白(FC)评估克罗恩病活动性的临床价值。方法选取2018年4月—2024年1月扬州大学附属医院确诊的克罗恩病患者76例,收集临床资料进行回顾性分析。根据克罗恩病简化内镜评分(SES-CD),将上述患者分为3组:缓解期20例、轻度活动期23例、中重度活动期33例。测量患者CTE定量参数。使用鞘流阻抗法测定患者外周血中血小板、淋巴细胞和中性粒细胞的数量,计算血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)。采用荧光免疫层析法测定粪便钙卫蛋白(FC)含量。结果SES-CD与肠壁厚度、静脉期CT值呈高度正相关(r>0.7,P均<0.001);与静脉期ΔCT、动脉期CT值和动脉期ΔCT呈中度正相关(r>0.5,P均<0.001);与FC呈高度正相关(r=0.883,P<0.001)。肠壁厚度、动脉期CT值、静脉期CT值与静脉期ΔCT在缓解期与轻度活动期之间、轻度活动期与中重度活动期之间比较,差异有统计学意义(P<0.05)。FC在缓解期与轻度活动期之间比较,动脉期ΔCT和FC在轻度活动期与中重度活动期之间比较,差异有统计学意义(P<0.05)。肠壁厚度、静脉期CT值联合FC评估克罗恩病活动性的AUC最高(AUC=0.993,95%CI 0.903~1.000)。结论CTE定量参数联合FC可有效评估克罗恩病的活动性。Objective To explore the clinical value of CT enterography(CTE)and fecal calprotectin(FC)in assessing the activity of Crohn disease(CD).Methods A total of 76 patients who were diagnosed with Crohn disease at the Affiliated Hospital of Yangzhou University from April 2018 to January 2024 were selected and their clinical data were collected for retrospective analysis.According to the Simple Endoscopic Score for Crohn Disease(SES-CD),the patients were divided into three groups:remission(n=20),mild activity(n=23),and moderate-to-severe activity(n=33).Quantitative parameters related to CTE were measured.The platelet,lymphocyte,and neutrophil counts in peripheral blood samples were determined by sheath flow impedance method,and the platelet-to-lymphocyte ratio(PLR)and neutrophil-to-lymphocyte ratio(NLR)were calculated.Fecal calprotectin(FC)levels were measured using fluorescence immunochromatography.Results SES-CD was highly positively correlated with bowel wall thickness and venous phase CT value(r>0.7,both P<0.001),moderately positively correlated with venous phaseΔCT,arterial phase CT value and arterial phaseΔCT(r>0.5,both P<0.001),and highly positively correlated with FC(r=0.883,P<0.001).Significant differences were observed in bowel wall thickness,arterial phase CT value,venous phase CT value,and venous phaseΔCT between the remission and mild activity groups and between the mild activity and moderate-tosevere activity groups(P<0.05).There were also significant differences in FC between the remission and the mild activity groups,and arterial phaseΔCT and FC between the mild activity and moderate-to-severe activity groups(P<0.05).The combination of bowel wall thickness,venous phase CT value and FC showed the highest AUC in assessing Crohn disease activity(AUC=0.993,95%CI 0.903-1.000).Conclusions The combination of quantitative CTE parameters and FC can effectively assess Crohn disease activity.

关 键 词：小肠CT造影 粪便钙卫蛋白 克罗恩病 缓解期 活动性 肠壁厚度 

分 类 号：R814.42[医药卫生—影像医学与核医学]