粪钙卫蛋白在腹部不适患者中的诊断价值

The evaluation of fecal calprotectin in patients with abdominal discomfort

目的评价粪钙卫蛋白在腹部不适患者中的临床诊断价值。方法收集长沙市芙蓉区红十字医院2009～2011年234例腹部不适患者,采用酶联免疫吸附试验检测粪钙卫蛋白,并进行统计学分析。结果腹部不适患者内镜下异常(n=83)的粪钙卫蛋白明显高于内镜下正常的患者(n=151),差异有统计学意义(P<0.01),粪钙卫蛋白曲线下面积(AUC)为0.872(95%CI:0.85～0.91),有明显的诊断意义,当cut off值为50μg/g,诊断的灵敏度和特异性为71%和93%,阳性和阴性似然比为11.1和0.29,并且粪钙卫蛋白对鉴别诊断上消化道(AUC:0.721,95%CI:0.61～0.79)和结肠(AUC:0.932,95%CI:0.82～0.94)炎症也是个有用的指标,并且对结肠的诊断准确性更高(P<0.01),而且粪钙卫蛋白的水平与胃黏膜损害程度相关。结论粪钙卫蛋白作为一项非侵入性指标对诊断腹部不适具有良好的临床意义。

Objective To evaluated the diagnostic value of fecal calprotectin in patients with abdominal discomfort. Methods 234 consecutive patients with abdominal discomfort in our hospital were enrolled from 2009 to 2011. Calproteetin was measured by ELISA and analyzed statistcally. Results Median calproteetin levels were higher in patients with significant findings（n=83） than in patients without（n= 151） ,which showed significant difference（P 〈0.01）. The area under the receiver operating characteristics curve （AUC） to identify a significant finding was 0.872（95% CI：0.85-0.91）.Using 50μg/g as cut off yielded a sensitivity of 71% and a specificity of 93% with good positive and negative likelihood ratios （11.1 and 0.29 ,respectively）. Fecal calprotectin was useful as a diagnostic parameter both for findings in the upper intestinal tract （AUC： 0. 721,95% CI： 0. 61- 0.79） and for the colon （AUC ： 0. 932,95% CI ： 0.82 - 0. 94） with higher diagnostic precision for the latter （P〈 0. 01 ）, moreover, calprotectin levels indicated disease severity in patients with mucosal lesions of the stomach. Conclusion In patients with abdominal discomfort,fecal calprotectin is a useful non-invasive marker to identify clinically significant findings of the gastrointestinal tract.