溃疡性结肠炎患者血清叉头框蛋白O1和高迁移率族蛋白A1与疾病活动度及短期预后的关系  

Relationships of serum forkhead box O1 and high mobility group protein A1 with disease activity and short-term prognosis of patients with ulcerative colitis

作　　者：侯宇格 段花玲 魏小娟[1] 歧红阳[1] HOU Yuge;DUAN Hualing;WEI Xiaojuan;QI Hongyang(Department of Gastroenterology,Xinziang Central Hospital,Xinriang,Henan 453000,China)

机构地区：[1]新乡市中心医院消化内科,河南新乡453000

出　　处：《中华实用诊断与治疗杂志》2025年第1期50-55,共6页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划项目(LHGJ20230882)。

摘　　要：目的 观察活动期溃疡性结肠炎(UC)患者血清叉头框蛋白O1(FOXO1)、高迁移率族蛋白A1(HMGA1)水平变化,探讨其与疾病活动度及短期预后的关系。方法 2022年6月—2024年5月新乡市中心医院诊治UC患者102例,入院后均采用ELISA法检测血清FOXO1、HMGA1水平,根据疾病活动度分为活动组(改良Mayo评分≥3分)75例和缓解组(改良Mayo评分<3分)27例。活动组给予美沙拉嗪+地塞米松治疗,缓解组给予美沙拉嗪治疗,14 d为1个疗程,根据病情治疗1~2个疗程。治疗2个月后根据肠黏膜恢复、临床症状改善情况,将活动组分为预后良好组59例和预后不良组16例。比较活动组与缓解组血清FOXO1、HMGA1水平;比较预后良好组与预后不良组临床资料和治疗前实验室指标;采用多因素logistic回归分析活动期UC患者短期预后的影响因素;绘制ROC曲线,评估血清FOXO1、HMGA1预测活动期UC患者短期预后的价值。结果 (1)活动组血清FOXO1水平[(11.04±2.26)μg/L]低于缓解组[(15.37±2.59)μg/L](t=8.209,P<0.001),血清HMGA1水平[(134.55±13.61)μg/L]高于缓解组[(102.65±11.37)μg/L](t=10.879,P<0.001)。(2)预后不良组年龄≥60岁(68.75%)、病程≥5年(56.25%)、有肠外表现(50.00%)比率均大于预后良好组(33.90%、25.42%、20.34%)(χ^(2)=4.247~6.305,P均<0.05),红细胞沉降率[(31.74±4.22)mm/h]、白细胞计数[(8.89±1.57)×10^(9)/L]、血清HMGA1水平[(146.27±14.06)μg/L]均高于预后良好组[(23.65±3.71)mm/h、(7.02±1.16)×10^(9)/L、(121.49±12.52)μg/L](t=5.285~7.513,P均<0.001),血红蛋白[(102.57±11.26)g/L]、血清FOXO1水平[(7.93±1.44)μg/L]均低于预后良好组[(112.38±12.05)g/L、(13.16±2.31)μg/L](t=2.927,P=0.005;t=8.590,P<0.001),体质量指数、合并症等临床资料与预后良好组比较差异均无统计学意义(P>0.05)。(3)病程(OR=2.298,95%CI:1.577~3.348,P<0.001)、肠外表现(OR=1.937,95%CI:1.374~2.729,P<0.001)、红细胞沉降率(OR=2.106,95%CI:1.463~3.033,P<0.001)、血清FOXO1(ORObjective To observe the changes in the serum levels of forkhead box O1(FOXO1) and high mobility group protein A1(HMGA1) in patients with active ulcerative colitis(UC),and to explore their relationships with disease activity and short-term prognosis.Methods From June 2022to May 2024,102patients with UC were treated in Xinxiang Central Hospital,and were divided into 75patients with modified Mayo≥3(the active group)and 27patients with modified Mayo<3(the remission group)based on disease activity.The serum FOXO1and HMGA1levels were measured with ELISA after admission in both groups.The active group received mesalazine and dexamethasone,while the remission group received mesalazine,totally for 1 to 2courses(14das one course).The patients in the active group were divided into the good prognosis group(n=59)and the poor prognosis group(n=16)according to the recovery of intestinal mucosa and alleviation of clinical symptoms after 2-month treatment.The serum FOXO1 and HMGA1 levels were compared between the active group and the remission group.The clinical data and pretreatment laboratory indicators were compared between the good prognosis group and the poor prognosis group.Multivariate logistic regression analysis was done to investigate the influencing factors of short-term prognosis in active UC patients,and ROC curves were plotted to evaluate the predictive values of serum FOXO1and HMGA1.Results(1)The serum FOXO1level was lower in the active group [(11.04±2.26)μg/L]than that in the remission group [(15.37±2.59)μg/L](t=8.209,P<0.001),while the serum HMGA1level was higher in the active group [(134.55±13.61)μg/L]than that in the remission group[(102.65±11.37)μg/L](t=10.879,P<0.001).(2)The rates of age≥60years,disease duration≥5years,and extraintestinal manifestations were higher in the poor prognosis group(68.75%,56.25%,50.00%)than those in the good prognosis group(33.90%,25.42%,20.34%)(χ^(2)=4.247-6.305,all P values <0.05).The erythrocyte sedimentation rate,white blood cell count and HMGA1level were higher

关 键 词：溃疡性结肠炎 叉头框蛋白O1 高迁移率族蛋白A1 疾病活动度 短期预后 

分 类 号：R574.62[医药卫生—消化系统]