钙卫蛋白、乳铁蛋白在溃疡性结肠炎患者中表达的临床研究

Clinical Analysis of Expressions of Calprotectin and Lactoferrin in Patients with Ulcerative Colitis

背景：溃疡性结肠炎（UC）是慢性反复发作的肠道炎性疾病,评估疾病活动度对其疗效判断非常重要,实验室标记物尤其是粪便标记物可很好地反映疾病活动度.目的：探讨钙卫蛋白（Cal）、乳铁蛋白（Lf）在UC患者结肠黏膜和粪便中表达的临床意义.方法：选取1998年1月～2008年1月安徽医科大学第一附属医院收治的具备完整结肠镜或手术病理检查结果的UC患者120例.以临床活动度指数（CAI）评分进行疾病分期,以免疫组化SP法检测结肠黏膜Cal、Lf表达,以ELISA法检测粪便Cal、Lf含量.结果：活动期UC患者结肠黏膜中均表达Cal、Lf.缓解期无或仅弱表达.活动期UC患者粪便Cal、Lf含量显著高于缓解期（P〈0.01）.UC患者结肠黏膜Cal和Lf表达以及粪便Cal和Lf含量均与CAI评分呈正相关（P=0.000）.粪便Cal和Lf含量与结肠黏膜Cal和Lf表达亦呈正相关（r=0.588,P=0.000;r=0.519,P=0.000）,且判断UC活动性的敏感性和特异性均较高.结论：UC患者结肠黏膜Cal、Lf表达可反映临床严重度,粪便Cal、Lf含量与UC活动性显著相关.

Background： Ulcerative colitis （UC） is a chronic, idiopathic intestinal inflammatory disorder characterized by a relapsing course. Evaluation of disease activity is essential for the judgment of therapeutic efficacy. The testing of biomarkers, particularly fecal measurements may possibly be used to reflect disease activity. Aims： To investigate the clinical significance of expressions of calprotectin （Cal） and lactoferrin （Lf） in colonic mucosa and their levels in feces in patients with UC. Methods： A total of 120 patients with UC undergone endoscopic examination or surgery from January 1998 to January 2008 at The First Affiliated Hospital of Anhui Medical University were enrolled. The disease staging was defined by clinical activity index （CAI） score. The expressions of Cal and Lf in colonic mucosa were determined by immunohis^ochemical SP staining. ELISA assay was used to measure the fecal levels of Cal and Lf. Results： Significant positive expressions of Cal and Lf were demonstrated in colonic mucosa in UC patients in active stage, while negative or weakly positive expression was observed in remission stage. The fecal levels of Cal and Lf were higher in UC patients in active stage than those in UC patients in remission stage （P〈O.01）, The expressions of Ca1 and Lf in colonic mucosa and fecal levels of Cal and Lf were all significantly correlated with CAI score （P=0.000）. The fecal levels of Cal and Lf and the expressions of Cal and Lf in colonic mucosa were both positively correlated （r=0.588, P=0.000; r=0.519, P=0.O00）, and had high sensitivities and specificities for judgment of UC activity. Conclusions： Expressions of Cal and Lf in colonic mucosa reflect the clinical degree of UC, and the fecal levels of Cal and Lf are significantly correlated with UC activity.