粪钙卫蛋白、乳铁蛋白水平与克罗恩病肠黏膜病变的关系

The correlation of fecal calprotectin and iactoferrin with intestinal mucosa lesions in Crohn＇s disease patients

目的研究粪钙卫蛋白、乳铁蛋白水平与克罗恩病肠黏膜病变的关系。方法选取88例经确诊的克罗恩病（CD）患者为研究对象，35例肠易激综合征（IBS）患者为对照。CD患者于肠镜检查前1周内、IBS患者于门诊就诊时分别留取粪便标本。其中CD患者同时计算CD活动指数（CDAI），并在其后的内镜检查中计算CD内镜指数（CDEI）。通过酶联免疫吸附法检测粪钙卫蛋白和乳铁蛋白水平。结果CD患者粪钙卫蛋白、乳铁蛋白水平[中位值（四分位数间距）]分别为277．16（96．85～693．57）mg／kg和59．68（10．75～100．58）mg／kg，明显高于IBS患者[7．6（5．54～32．3）mg／kg和0．65（0．23～4．34）mg／kg]，差异均有统计学意义（Z值分别=-8．301和-7．986，P值均=0．000）。存在结肠病变的CD患者粪钙卫蛋白、乳铁蛋白水平与无结肠病变的CD患者比较差异均无统计学意义（Z值分别=-0．424和-0．699，P值分别=0．672和0．485）。CD缓解期者粪钙卫蛋白、乳铁蛋白水平与CD活动期者比较，差异均无统计学意义（Z值分别=-1.491和-1．075，P值分别=0．136和0．283）。内镜中重度活动期者粪钙卫蛋白、乳铁蛋白水平分别为663．11（263．45～2015．63）mg／kg、105．64（56．52～187．44）mg／kg，轻度活动期者分别为344．54（132．03～722．67）mg／kg、86．68（21．07～100．55）mg／kg，静止期者分别为133．94（60．54～583．33）mg／kg、45．31（7．59-48．31）mg／kg，各活动期患者粪钙卫蛋白和乳铁蛋白水平高于静止期（x^2分别=10．63和8．18，P值分别=0．005和0．017）。结论粪钙卫蛋白、乳铁蛋白水平可反映肠道黏膜病变及其严重程度。

Objective To study the correlation of fecal calprotectin and lactoferrin with intestinal mueosa lesions in Crohn＇s disease （CD）. Methods Elghty-dgbt cases of diagnosed CD patients were selected as study group and a5 irritable bowel syndrome （IBS） patients were as controls. Fecal samples of CD patients were collected in one week before colonoscopy examination and of IBS patients were collected of CD patients, CD activity index （CDAI） was calculated at same visit, and CD endoscopic index （CDEI） was calculated in the subsequent endoscopic examination. The level of fecal calprotectin and lactoferrin were tested by ELISA method. Results The median levels of facal calprotectin and lactoferrin in CD patients were 277. 16 mg/kg （from 96. 85 to 693. 57 mg/kg） and 59.68 mg/kg （from 10. 75 to 100. 58 mg/kg） respectively, which were significantly higher than those of IBS patients （7.6mg/kg, from 5.54 to 32.3 mg/kg and 0, 65 mg/kg from 0.23 to 4 （Z=-8. 301 and -7. 986, respectively both P 20. 000）. There calprotectin and lactoferrin level between CD patients with colon p were no significant athological 34 mg/kg）, difference of and without colon pathological changes （Z=-0. 424 and -0. 699,P=0. 672 and 0. 485, respectively）.There was no significant difference of calprotectin and lacoferrin level between remission and active periods in CD patients （Z=-1. 491 and -1. 075, P=0. 136 and 0. 283, respectively）. The median values of calprotectin and lactoferrin of patients in moderate and severe active period judged under endoscopy were 663.11 mg/kg （from 2G3.45 to 2015. 63 rng/kg） and 105. 64 mg/kg （from 56. 52 to 187.44） mg/kg respectively, in mild active period were 344. 54 mg/kg （from 132.03 to 722. 67 mg/kg） and 86.68 mg/kg （from 21.07 to 100.55 mg/kg） accordingly, and in remission period were 133.94 mg/kg （from 60.54 to 583.33 mg/kg） and 45.31 mg/kg （from 7.59 to 48.31 mg/kg, respectively）. Both calprotectin and lactoferrin levels were significantly higher in active period than in remission period （x^2 =10.63 and 8. 18, while, P=0. 005 and 0. 017, respectively）. Conclusions The level of fecal calprotectin and lactoferrin can reflect the pathological changes and severity of the intestinal mucosa.