实验室检查在溃疡性结肠炎诊断中的意义

Significance of Laboratory Examination in The Diagnosis of Ulcerative Colitis

目的总结实验室检查在溃疡性结肠炎(UC)诊断中的意义。方法通过检索国内外相关文献,从实验室检查方面阐明其在诊断UC中的临床意义并作综述。结果对于UC的诊断,在实验室检查方面,抗中性粒细胞胞浆抗体(ANCA)对诊断UC具有一定的价值,但是其在评价UC活动性方面有所受限。UC患者的抗小肠杯状细胞抗体(GAB)阳性率比克罗恩病(CD)患者要高,其可以作为该两种疾病的鉴别指标,但该指标不能很好地反映疾病的严重程度。人抗酿酒酵母抗体(ASCA)及抗胰腺腺泡抗体(PAB)主要用于UC及CD的鉴别诊断,因为其在诊断UC方面均无明显优势。粪钙卫蛋白(FCP)在评价UC复发及活动性方面均有着积极的作用。虽然乳铁蛋白、M2型丙酮酸激酶(M2-PK)及S100A12的诊断效果不如FCP明显,但若联合检测以共同对UC进行诊断与评估,对于指导临床具有重要的意义。结论对于UC的诊断,在实验室检查相关指标中,FCP在评价UC复发及活动性方面均有着重要的作用。

Objective To summarize the significance of laboratory examinations in diagnosis of ulcerative colitis （UC）. Methods Literatures at home and abroad were searched to review the clinical significance of laboratory examin-ations indexes in diagnosis of UC. Results Anti-neutrophilcytoplasmicantibodies （ANCA） had some value in diagnosis of UC, but it was limited in evaluation of UC in active patients. The positive rate of anti-intestinal goblet cell antibody （GAB） in patients with UC was higher than that of patients with Crohn＇s disease （CD）, so it could be used as identifica-tion indexes of the two diseases, but it could not reflect the severity of the disease. Anti-saccharomyces cerevisiae antibo- dies （ASCA） and anti-pancreatic antibody （PAB） were mainly used in the differential diagnosis of UC and CD, but they had no significant advantages in diagnosis of UC. Fecal calprotectin （FCP） played a positive role in evaluation of recurr-ence and activity in UC. Although lactoferrin, M2-pyruvate kinase （M2-PK）, and S100A12 were not as effective as FCP, but if combined with related indicators, they were also important. Conclusion Of the relevant indexes of laboratory examination in the diagnosis ofUC, FCP plays an importent role in the evaluation of recurrence and activity of UC.