粪便钙卫蛋白判断消化性溃疡活动性的临床价值

Fecal calprotectin in estimation of activity of peptic ulcers

目的探讨粪便钙卫蛋白（FCP）判断消化性溃疡（PU）活动性的临床价值，并与常规胃镜检查结果行对比研究。方法胃镜确诊消化性溃疡患者62例，胃镜检查后3d内留取粪便5～10g，应用ELISA法检测粪便钙卫蛋白；同时收集患者病史及临床资料。正常对照组30例，均为健康体检正常的成人。结果62例PU组FCP检测值（154．72μg／g）显著高于正常对照组（25．18μg／g）（P〈0．001）；PU组活动期FCP检测值（318．34μg／g）与瘢痕期（54．10μg／g）、对照组（25．18μg／g）相比较也均有统计学意义（P〈0．01）；后两者之间的差异无统计学意义（P〉0．05）。FCP检测值与溃疡部位、大小、数目之间无明显关系（P〉0．05）。PU组中上消化道出血者FCP检测值（1257．41μg／g）显著高于其他症状者（92．77μg／g）（P〈0．001）。结论FCP的表达水平与消化性溃疡患者溃疡活动性及临床表现密切相关，FCP可作为检测消化性溃疡患者溃疡活动性指标之一。

Objective To explore the clinical value of fecal calprotectin （FCP） in peptic ulcer （PU） as an non-invasive indicator of disease activity compared with gastroscope. Methods The study was conducted in 62 patients with PU confirmed by endoscopy （PU group） and 30 subjects with normal findings under endoscopy （ control group）. Fecal sample （ weight 5-10 g） was collected within 3 days after endoscopy and FCP was measured by emzyme-linked immunosorbent assay （ELISA）. The case history and clinical data were collected as well. Results The level of FCP in PU group was significantly higher than that in control group （ 154. 72μg/g vs. 25. 18 μg/g, P 〈0. 001 ）. In patients with PU at active stage （n =32） , the level of FCP was significantly higher than that at scar stage （n =30, 318.34 μg/g vs. 54. 10 μg/g, P 〈0. 01 ）, and that in control group （25. 18 μg/g, P 〈0. 01 ） , while there was no significant difference in FCP between the latter two groups （ P 〉 0. 05 ）. The level of FCP had no significant correlation with the location, size or number of the ulcer. Among patients in PU group, the level of FCP in patients presented with haematemesis or melena （ n = 20） was significantly higher than that in patients presented with other symptoms （ n = 42, 1257.41 μg/g vs. 92. 77 μg/g, P 〈 0. 01 ）. Conclusion The level of FCP is closely correlated with the activity of PU, which is significantly higher at active stage than that at scar stage, as well as in PU patients with bleeding than those without. Measurement of FCP is a convenient and noninvasive method with well compliance of patients, which might be used as an indicator of disease activity in PU.