血管内皮生长因子和D-二聚体水平在缺血性结肠炎早期诊断中的价值  

Vascular Endothelial Growth Factor and D⁃Dimer Levels for Early Diagnosis of Ischemic Colitis

作　　者：卢翀 陈媛 胡敏鹂 魏姣姣 丁进 王群英 LU Chong;CHEN Yuan;HU Minli;WEI Jiaojiao;DING Jin;WANG Qunying(Department of Gastroenterology,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua,Zhejiang Province,321000)

机构地区：[1]浙江大学医学院附属金华医院消化内科,321000

出　　处：《胃肠病学》2024年第7期409-413,共5页Chinese Journal of Gastroenterology

基　　金：金华市科技计划项目(2021-4-030)。

摘　　要：背景:缺血性结肠炎是一种因肠壁缺血引起的消化道急症,严重者甚至会危及生命。目前,缺血性结肠炎缺乏可靠的检测方法,临床上迫切需要一种特异性检测手段以提高缺血性结肠炎的早期诊断率。目的:探讨血清血管内皮生长因子(VEGF)和血浆D-二聚体水平在缺血性结肠炎早期诊断中的价值。方法:将2021年6月—2023年6月期间浙江大学医学院附属金华医院确诊为缺血性结肠炎的40例患者作为试验组,同时以51例急性肠炎患者作为对照组,比较两组患者的临床表现、实验室、影像学和内镜检查结果。采用二元Logistic回归模型分析早期缺血性结肠炎的危险因素,利用ROC曲线分析血清VEGF、血浆D-二聚体水平对缺血性结肠炎的早期诊断效能。结果:与对照组相比,试验组患者腹痛伴便血的比例、血清VEGF和血浆D-二聚体水平显著升高(P均<0.05)。二元Logistic回归模型分析结果显示血清VEGF和血浆D-二聚体水平为早期缺血性结肠炎的危险因素(P均<0.05)。ROC曲线分析结果显示,血清VEGF和血浆D-二聚体诊断缺血性结肠炎的曲线下面积(AUC)分别为0.93和0.88,两者联合能进一步提高诊断特异性和AUC。结论:血清VEGF和血浆D-二聚体水平可作为缺血性结肠炎早期诊断的标志物,两者联合可显著提高缺血性结肠炎的早期诊断效能。Background:Ischemic colitis is a gastrointestinal emergency caused by intestinal wall ischemia,and in severe cases,it can even be life-threatening.Currently,there is a lack of reliable detection methods for ischemic colitis.Clinically,there is an urgent need for a specific detection method to improve the early diagnosis rate of ischemic colitis.Aims:To explore the values of serum vascular endothelial growth factor(VEGF)and plasma D-dimer levels for early diagnosis of ischemic colitis.Methods:A total of 40 patients with ischemic colitis admitted from June 2021 to June 2023 at the Affiliated Jinhua Hospital,Zhejiang University School of Medicine were served as the experimental group.Meanwhile,51 patients with acute enteritis were served as controls.The clinical manifestations,as well as the laboratory,radiological,and endoscopic results were compared between the two groups.A binary Logistic regression model was employed to analyze the risk factors for the onset of ischemic colitis.ROC curve was used to assess the diagnostic performance of serum VEGF and plasma D-dimer levels for the early diagnosis of ischemic colitis.Results:Compared with the control group,the proportion of patients with abdominal pain accompanied by hematochezia,and the serum VEGF and plasma D-dimer levels in the experimental group were significantly increased(all P<0.05).The results of binary Logistic regression model indicated that serum VEGF and plasma D-dimer levels were the risk factors for onset of ischemic colitis(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum VEGF and plasma D-dimer for diagnosing ischemic colitis were 0.93 and 0.88,respectively.The combination of these two indicators could further increase the diagnostic specificity and the AUC.Conclusions:Serum VEGF and plasma D-dimer levels can be served as early diagnostic markers for ischemic colitis.The combination of these two indicators can greatly improve the early diagnostic performance.

关 键 词：结肠炎 缺血性 血管内皮生长因子 D-二聚体 诊断 

分 类 号：R73[医药卫生—肿瘤]