目的 探討糞鈣衛(wèi)蛋白在潰瘍性結(jié)腸炎(UC) 活動(dòng)性評(píng)價(jià)中的臨床意義。
方法 收集2007年9月至2009年12月期間中國(guó)醫(yī)科大學(xué)附屬第四醫(yī)院肛腸外科確診為UC的患者63例及結(jié)腸鏡檢查結(jié)果正常但存在相應(yīng)消化道癥狀的患者30例,檢測(cè)并比較其糞鈣衛(wèi)蛋白、紅細(xì)胞沉降率及C反應(yīng)蛋白水平。
結(jié)果 活動(dòng)期Ⅰ、Ⅱ及Ⅲ級(jí)組的糞鈣衛(wèi)蛋白和C反應(yīng)蛋白水平均高于對(duì)照組和緩解組(P<0.05),且隨活動(dòng)期級(jí)別增高,糞鈣衛(wèi)蛋白的水平逐漸增高(P<0.05);活動(dòng)期Ⅱ級(jí)及Ⅲ級(jí)組的C反應(yīng)蛋白水平均高于Ⅰ級(jí)組(P<0.05),但前兩者比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05);5組紅細(xì)胞沉降率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。UC活動(dòng)組的糞鈣衛(wèi)蛋白水平(rs=0.807,P<0.01)、C反應(yīng)蛋白水平(rs=0.651,P<0.01)和紅細(xì)胞沉降率(rs=0.371,P<0.05)均與結(jié)腸鏡下分級(jí)相關(guān)。
結(jié)論 糞鈣衛(wèi)蛋白可用于評(píng)價(jià)UC的活動(dòng)性。由于其檢測(cè)方法簡(jiǎn)單、無(wú)創(chuàng)、方便及依從性好,具有一定的臨床意義。
引用本文: 鄶國(guó)虎,李春雨. 糞鈣衛(wèi)蛋白在潰瘍性結(jié)腸炎活動(dòng)性分級(jí)評(píng)價(jià)中的臨床意義. 中國(guó)普外基礎(chǔ)與臨床雜志, 2013, 20(6): 648-651. doi: 復(fù)制
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3. | 中華醫(yī)學(xué)會(huì)消化病學(xué)分會(huì)炎癥性腸病協(xié)作組. 中國(guó)炎癥性腸病診斷治療規(guī)范的共識(shí)意見(jiàn)[J]. 中華內(nèi)科雜志, 2008, 47(1):73-79. |
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7. | Rugtveit J, Brandtzaeg P, Halstensen TS, et al. Increased macrophage subset in inflammatory bowel disease:apparent recruitment from peripheral blood monocytes[J]. Gut, 1994, 35(5):669-674. |
8. | Røseth AG, Aadland E, Jahnsen J, et al. Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein[J]. Digestion, 1997, 58(2):176-180. |
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12. | 馬列婷, 王亞文, 喬文. 糞便鈣衛(wèi)蛋白對(duì)潰瘍性結(jié)腸炎診斷的臨床價(jià)值[J]. 西安交通大學(xué)學(xué)報(bào):醫(yī)學(xué)版, 2008, 29(3):321-323. |
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18. | Solem CA, Loftus EV Jr, Tremaine WJ, et al. Correlation ofC-reactive protein with clinical, endoscopic, histologic, and radio-graphic activity in inflammatory bowel disease[J]. Inflamm Bowel Dis, 2005, 11(8):707-712. |
19. | Manz M, Burri E, Rothen C, et al. Value of fecal calprotectin in the evaluation of patients with abdominal discomfort:an observational study[J]. BMC Gastroenterol, 2012, 12:5. |
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23. | Fagerhol MK. Calprotectin, a faecal marker of organic gastrointestinal abnormality[J]. Lancet, 2000, 356(9244):1783-1784. |
24. | Mao R, Xiao YL, Gao X, et al. Fecal calprotectin in predicting relapse of inflammatory bowel diseases:a meta-analysis of pros-pective studies[J]. Inflamm Bowel Dis, 2012, 18(10):1894-1899. |
25. | Schoepfer AM, Beglinger C, Straumann A, et al. Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the lichtiger index, C-reactive protein, platelets, hemoglobin, and blood leukocytes[J]. Inflamm Bowel Dis, 2013, 19(2):332-341. |
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27. | , 64(5):421-425. |
- 1. 宋璐, 夏冰. 潰瘍性結(jié)腸炎發(fā)病機(jī)制及其診斷[J]. 中國(guó)實(shí)用內(nèi)科雜志, 2010, 30(11):1056-1058.
- 2. Masoodi I, Tijjani BM, Wani H, et al. Biomarkers in the manag-ement of ulcerative colitis:a brief review[J]. Ger Med Sci, 2011,.
- 3. 中華醫(yī)學(xué)會(huì)消化病學(xué)分會(huì)炎癥性腸病協(xié)作組. 中國(guó)炎癥性腸病診斷治療規(guī)范的共識(shí)意見(jiàn)[J]. 中華內(nèi)科雜志, 2008, 47(1):73-79.
- 4. Truelove SC, Witts LJ. Cortisone in ulcerative colitis;final reporton a therapeutic trial[J]. Br BMJ J, 1955, 2(4947):1041-1048.
- 5. Cosnes J, Gower-Rousseau C, Seksik P, et al. Epidemiology and natural history of inflammatory bowel diseases[J]. Gastroenterology, 2011, 140(6):1785-1794.
- 6. Fagerhol MK, Dale I, Andersson T. A radioimmunoassay for a granulocyte protein as a marker in studies on the turnover of such cells[J]. Bull Eur Physiopathol Respir, 1980, 16 Suppl:273-282.
- 7. Rugtveit J, Brandtzaeg P, Halstensen TS, et al. Increased macrophage subset in inflammatory bowel disease:apparent recruitment from peripheral blood monocytes[J]. Gut, 1994, 35(5):669-674.
- 8. Røseth AG, Aadland E, Jahnsen J, et al. Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein[J]. Digestion, 1997, 58(2):176-180.
- 9. :Doc03.
- 10. Gisbert JP, McNicholl AG. Questions and answers on the role of faecal calprotectin as a biological marker in inflammatory bowel disease[J]. Dig Liver Dis, 2009, 41(1):56-66.
- 11. 沈姞, 李俊霞, 王化虹, 等. 糞便鈣衛(wèi)蛋白對(duì)潰瘍性結(jié)腸炎的診斷及預(yù)測(cè)復(fù)發(fā)的價(jià)值[J]. 腸外與腸內(nèi)營(yíng)養(yǎng), 2011, 18(5):272-276.
- 12. 馬列婷, 王亞文, 喬文. 糞便鈣衛(wèi)蛋白對(duì)潰瘍性結(jié)腸炎診斷的臨床價(jià)值[J]. 西安交通大學(xué)學(xué)報(bào):醫(yī)學(xué)版, 2008, 29(3):321-323.
- 13. Amati L, Passeri ME, Selicato F, et al. New insights into the biological and clinical significance of fecal calprotectin in inflammatory bowel disease[J]. Immunopharmacol Immunotoxicol, 2006, 28(4):665-681.
- 14. Costa F, Mumolo MG, Ceccarelli L, et al. Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn’s disease[J]. Gut, 2005, 54(3):364-368.
- 15. Tibble JA, Sigthorsson G, Bridger S, et al. Surrogate markers of intestinal inflammation are predictive of relapse in patients with inflammatory bowel disease[J]. Gastroenterology, 2000, 119(1):15-22.
- 16. 張穎, 王英德. 糞便鈣衛(wèi)蛋白、抗中性粒細(xì)胞胞漿抗體檢測(cè)在潰瘍性結(jié)腸炎診斷中的價(jià)值比較[J]. 中華臨床醫(yī)師雜志:電子版, 2012, 6(6):1620-1622.
- 17. Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD:useful, magic, or unnecessary toys?[J]. Gut, 2006, 55(3):426-431.
- 18. Solem CA, Loftus EV Jr, Tremaine WJ, et al. Correlation ofC-reactive protein with clinical, endoscopic, histologic, and radio-graphic activity in inflammatory bowel disease[J]. Inflamm Bowel Dis, 2005, 11(8):707-712.
- 19. Manz M, Burri E, Rothen C, et al. Value of fecal calprotectin in the evaluation of patients with abdominal discomfort:an observational study[J]. BMC Gastroenterol, 2012, 12:5.
- 20. Erbayrak M, Turkay C, Eraslan E, et al. The role of fecal calprotectin in investigating inflammatory bowel diseases[J]. Clinics,.
- 21. Schoepfer AM, Beglinger C, Straumann A, et al. Ulcerative colitis:correlation of the rachmilewitz endoscopic activity index with fecal calprotectin, clinical activity, C-reactive protein, and blood leukocytes[J]. Inflamm Bowel Dis, 2009, 15(12):1851-1858.
- 22. Lamb CA, Mohiuddin MK, Gicquel J, et al. Faecal calprotectin or lactoferrin can identify postoperative recurrence in Crohn’s disease[J]. Br J Surg, 2009, 96(6):663-674.
- 23. Fagerhol MK. Calprotectin, a faecal marker of organic gastrointestinal abnormality[J]. Lancet, 2000, 356(9244):1783-1784.
- 24. Mao R, Xiao YL, Gao X, et al. Fecal calprotectin in predicting relapse of inflammatory bowel diseases:a meta-analysis of pros-pective studies[J]. Inflamm Bowel Dis, 2012, 18(10):1894-1899.
- 25. Schoepfer AM, Beglinger C, Straumann A, et al. Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the lichtiger index, C-reactive protein, platelets, hemoglobin, and blood leukocytes[J]. Inflamm Bowel Dis, 2013, 19(2):332-341.
- 26. 歐陽(yáng)欽. 潰瘍性結(jié)腸炎的治療[J]. 中國(guó)實(shí)用內(nèi)科雜志, 2010, 30(4):383-385.
- 27. , 64(5):421-425.