粪钙卫蛋白在溃疡性结肠炎诊断中的价值研究

Research about the value of fecal calprotectin in the diagnosis of ulcerative colitis

目的研究粪钙卫蛋白检测作为一种无创性方法用于诊断溃疡性结肠炎(UC)活动性的价值。方法UC患者72例,60例经结肠镜检查正常的患者作为对照,留取结肠镜检查后1周内的粪便样本10 g,采用ELISA方法进行粪钙卫蛋白检测,对19例活动期3级患者实施随访,监测粪钙卫蛋白水平变化。结果①粪钙卫蛋白水平差异在UC缓解期组和正常对照组之间无统计学意义,活动期组与缓解期组及活动期组和正常对照组之间均有统计学意义(597.2μg/g vs 7.9μg/g,6.7μg/g,P<0.01)。②活动期1级(109.5μg/g)、2级(587.9μg/g)和3级(1331.6μg/g)两两之间比较差异均有统计学意义(P<0.01)。③粪钙卫蛋白水平与UC内镜分级显著相关(r=0.89,P<0.01),19例UC活动期3级患者经治疗后至缓解期,粪钙卫蛋白水平显著下降,其治疗前后相比差异有统计学意义(1378.5μg/g vs 8.7μg/g,P<0.01)。结论粪钙卫蛋白水平可以较准确地反映UC患者所处不同时期(活动期或缓解期)以及活动期的不同严重程度(活动期1.2.3级),能较好地应用于临床诊断、观察疗效并指导用药。

Objective To research the value of fecal calprotectin as a non-invasive marker of disease activity in ulcerative colitis （UC）. Methods We recruited 60 control patients and 72 patients with UC. All the patients were asked to collect 10g fecal samples in 1 wk after colonoscopy. An ELISA （enzyme linked immunosorbent assay） was used to determine fecal calprotectin. 19 patients whose UC activity at 3 grade after medical therepy were conduct follow--up visits, to guide clinical therapy and observe effects based by the level of fecal calprotectin. Results There was no significant difference in fecal calprotectin level between the inactive UC and control groups. There are significant difference in fecal calprotectin level between patients with active and inactive UC（597. 2μg/g vs 7. 9μg/g, P 〈0. 01） ,and between patients with active UC and controls（597.2μg/g vs 6.7μg/g, P 〈0. 01）. And significant difference existed in active grades（1,2,3）of UC each other（109.5μg/g vs 587.9μg/g;587.9μg/g vs 1331.6μg/g;109.5μg/g vs 1331.6μg/g, P 〈0.01 ）. A significant correlation existed between the endoscopic grade of disease activity and fecal calpro- tectin concentration（ r =0.89, P d0.01） . Nineteen patients with grade 3 UC were cured to inactive UC, and fecal calprotectin level was significantly decreased （1378, 5gμg/g vs 8.7μg/g, P 〈0.01 ）. Conclusion Patients with active or inactive UC can be diagnosed by fecal calprotectin level and the guide function of fecal calprotectin to clinical medication of UC may be a better marker of curative effect.