粪钙卫蛋白在溃疡性结肠炎活动性分级评价中的临床意义

Value of Fecal Calprotectin in Activity Evaluation of Ulcerative Colitis

目的探讨粪钙卫蛋白在溃疡性结肠炎(UC)活动性评价中的临床意义。方法收集2007年9月至2009年12月期间中国医科大学附属第四医院肛肠外科确诊为UC的患者63例及结肠镜检查结果正常但存在相应消化道症状的患者30例,检测并比较其粪钙卫蛋白、红细胞沉降率及C反应蛋白水平。结果活动期Ⅰ、Ⅱ及Ⅲ级组的粪钙卫蛋白和C反应蛋白水平均高于对照组和缓解组(P<0.05),且随活动期级别增高,粪钙卫蛋白的水平逐渐增高(P<0.05);活动期Ⅱ级及Ⅲ级组的C反应蛋白水平均高于Ⅰ级组(P<0.05),但前两者比较差异无统计学意义(P>0.05);5组红细胞沉降率比较差异无统计学意义(P>0.05)。UC活动组的粪钙卫蛋白水平(rs=0.807,P<0.01)、C反应蛋白水平(rs=0.651,P<0.01)和红细胞沉降率(rs=0.371,P<0.05)均与结肠镜下分级相关。结论粪钙卫蛋白可用于评价UC的活动性。由于其检测方法简单、无创、方便及依从性好,具有一定的临床意义。

Objective To explore the value of fecal calprotectin（FCP）in the activity evaluation for ulcerative colitis（UC）.Methods Sixty three patients with UC（UC group）and 30 patients with gastrointestinal symptoms but without abnormal results of colonoscopy（control group）,who were treated in The Forth Affiliated Hospital of China Medical University between Sep.2007 to Dec.2009 were enrolled to examine the FCP,C-creative protein（CRP）,and erythrocyte sedimentation rate（ESR）.Then comparison between UC group and control group was performed.Results Levels of FCP and CRP in active grade Ⅰ,Ⅱ,and Ⅲ group were all significantly higher than those of control group and inactive UC group（P〈0.05）,with the increase of active grade of UC,the level of FCP gradually increased（P〈0.05）.The levels of CRP in active grade Ⅱ and Ⅲ group were all significantly higher than those of grade Ⅰ group（P〈0.05）,but didn’t differed between active grade Ⅱ and Ⅲ group（P〈0.05）.There were no significant difference among 5 groups on ESR（P〈0.05）.Levels of FCP（rs=0.807,P〈0.01）,CRP（rs=0.651,P〈0.01）,and ESR（rs=0.371,P〈0.05） in active grade group were significantly related to histological grade under colonoscopy.Conclusion FCP examination is simple,inexpensive,repeatable,and noninvasive,and FCP can be used as an marker of activity evaluation in UC.