粪便MMP-9对溃疡性结肠炎诊断价值的分析

Diagnostic value of fecal MMP-9 in ulcerative colitis

目的比较溃疡性结肠炎患者、功能性胃肠功能紊乱患者和正常对照组的粪便中基质金属蛋白酶-9(MMP-9)水平,研究其与疾病活动性、钙卫蛋白的相关性。方法选取衢州市人民医院2012年-2013年UC患者48例,IBS-D患者25例,正常健康人25例进行研究,并用Mayo得分评价UC严重性,检测粪便MMP-9和钙卫蛋白,然后进行统计学分析。结果正常对照组和IBS-D患者粪便MMP-9低于检测限或低于0.22 ng/ml,UC患者粪便MMP-9与Mayo(P<0.001)、内镜检查(P<0.001)和CRP(P=0.002)得分明显相关。此外,UC患者MMP-9与粪便钙卫蛋白亦有一定的相关性(r=0.492,P=0.013)。结论粪便MMP-9可成为区别UC、IBS-D患者和正常对照组的一个非侵入的有用指标,并可用来判断疾病活动性。

Objective To compare the fecal MMP-9 levels in ulcerative colitis（ UC） patients,patients with functional gastrointestinal disorder（ IBS-D patients as example） and healthy controls,so as to study the correlation between fecal MMP-9 level and disease activity,calprotectin. Methods From 2012 to 2013,48 UC patients,25 patients with diarrhea-predominant irritable bowel syndrome（ IBS-D） and 25 healthy controls were selected to detect the levels of fecal MMP-9 and calprotectin, then the results were analyzed by statistics. Mayo score was used to evaluate the disease severity of UC patients. Results Fecal MMP-9 was undetectable or less than 0. 22 ng/ ml in all controls and IBS-D patients,while that was high in UC patients. Fecal MMP-9 levels were significantly correlated with the overall Mayo score（ P 0. 001）,the endoscopic score（ P〈 0. 001）, and the serum C-reactive protein levels（ P = 0. 002） in UC patients. Additionally,fecal MMP-9 levels also showed significant correlation with fecal calprotectin in UC patients（ r = 0. 492,P = 0. 013）. Conclusion These results highlight fecal MMP-9 is a useful index in the differential diagnosis of UC,IBS-D and healthy controls,and it can be used to judge the disease activity of UC.