血清IL-6R和IL-22表达与溃疡性结肠炎严重程度及临床结局的关系  

Relationship between the expression of serum IL-6R and IL-22 and the severity and clinical outcome of ulcerative colitis

作　　者：费良 刘红霞 赵敬贤 颜悦蓉 聂琳 FEI Liang;LIU Hongxia;ZHAO Jingxian;YAN Yuerong;NIE Lin(Department of Gastroenterology,Jianli People's Hospital,Jianli,Hubei 433000,China;Emergency Department,Jianli People's Hospital,Jianli,Hubei 433000,China;Department of Gastroenterology,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Sciences,Xiangyang,Hubei 441021,China)

机构地区：[1]监利市人民医院消化内科,湖北监利433000 [2]监利市人民医院急诊科,湖北监利433000 [3]湖北文理学院附属襄阳市中心医院消化内科,湖北襄阳441021

出　　处：《安徽医药》2025年第1期48-52,共5页Anhui Medical and Pharmaceutical Journal

基　　金：湖北省自然科学基金(WJ2019AB085)。

摘　　要：目的探究血清白细胞介素-6受体(IL-6R)和白细胞介素-22(IL-22)表达与溃疡性结肠炎严重程度及临床结局的关系。方法选取监利市人民医院2017年12月至2022年6月治疗的212例溃疡性结肠炎病人为研究对象,根据其病情严重程度分为轻症组与重症组,根据治疗2个月的预后情况分为预后良好组与预后不良组,采用酶联免疫吸附测定检测IL-6R、IL-22水平并收集病人临床资料,logistic多因素回归分析影响溃疡性结肠炎病人预后的相关因素;绘制受试者操作特征曲线(ROC曲线)预测IL-6R和IL-22对溃疡性结肠炎严重程度以及预后的临床诊断及预测价值。结果与轻症组[(11.10±1.21)ng/L、(50.24±6.35)ng/L]相比,重症组在入院时的血清IL-6R[(15.32±2.62)ng/L]、IL-22水平[(63.61±6.95)ng/L]显著增加(P<0.05),通过绘制ROC曲线发现IL-6R、IL-22以及两者联合诊断重症溃疡性结肠炎的曲线下面积(AUC)分别为0.85、0.85、0.92,并且二者联合诊断显著优于IL-6R、IL-22单独诊断(Z=3.58,3.42;P=0.003,0.006);通过分析病人一般临床资料发现,溃疡性结肠炎病人的预后与病人是否有肠外表现、C反应蛋白(CRP)、降钙素原(PCT)、红细胞沉降率(ESR)、粪便钙卫蛋白(FC)、粪便乳铁蛋白(FL)、IL-6R以及IL-22水平有关(P<0.05),与性别、年龄无关(P>0.05),logistic多因素回归分析发现,CRP、PCT、ESR、FC、FL、IL-6R以及IL-22均为影响溃疡性结肠炎病人预后的危险因素(P<0.05)。绘制ROC曲线发现IL-6R、IL-22以及两者联合预测溃疡性结肠炎病人预后的AUC分别为0.81、0.83、0.90,并且二者联合预测显著优于IL-6R、IL-22单独预测(Z=3.70,3.18;P<0.001,P=0.002)。结论溃疡性结肠炎病人血清IL-6R、IL-22水平随病人病情严重程度增加,均为影响溃疡性结肠炎病人预后的危险因素,并且对病人的病情严重程度及临床结局预测具有辅助诊断价值。Objective To explore the relationship between the expression of serum interleukin-6 receptor(IL-6R)and interleukin-22(IL-22)and the severity and clinical outcome of ulcerative colitis.Methods Two hundred and twelve patients with ulcerative colitis treated in Jianli People´s Hospital from December 2017 to June 2022 were as research objects,according to the severity of their condition,they were grouped into mild and severe group,according to the prognosis after 2 months of treatment,they were grouped into a good prognosis group and a poor prognosis group,enzyme linked immunosorbent assay(ELISA)was applied to detect IL-6R and IL-22 levels,and clinical data were collected from patients,Logistic regression was applied to analyze the related factors affected the prognosis of patients with ulcerative colitis;receiver operating characteristic was drawn to predict the clinical diagnostic and predictive value of IL-6R and IL-22 for severity and prognosis of ulcerative colitis.Results Compared with the mild group[(11.10±1.21)ng/L,(50.24±6.35)ng/L],the serum levels of IL-6R[(15.32±2.62)ng/L]and IL-22[(63.61±6.95)ng/L]in the severe group were obviously increased at admission(P<0.05),by drawing the receiver operating characteristic,it was found that the AUC of IL-6R,IL-22 and their combined diagnosis of severe ulcerative colitis was 0.85,0.85 and 0.92,respectively,and their combined diagnosis was obviously better than that of IL-6R and IL-22 alone(Z=3.58,3.42;P=0.003,0.006);by analyzing the general clinical data of the patients,it was found that the prognosis of patients with ulcerative colitis was related to whether they had extraintestinal manifestations,C-reactive protein(CRP),procalcitonin(PCT),erythrocytesedimentrate(ESR),faecal calreticulin(FC),faecal lactoferrin(FL),IL-6R and IL-22 levels(P<0.05),but not to gender and age(P>0.05),multiple Logistic regression analysis showed that CRP,PCT,ESR,FC,FL,IL-6R and IL-22 were all risk factors affecting the prognosis of ulcerative colitis patients(P<0.05).Receiver operating

关 键 词：结肠炎 溃疡性 白细胞介素-6受体 白细胞介素-22 病情严重程度 临床结局 

分 类 号：R574.62[医药卫生—消化系统]