血浆抗凝血酶Ⅲ和血清IL-6与降钙素原对判断克罗恩病活动性的临床价值

Clinical value of plasma AT-Ⅲ and serum PCT,IL-6 levels and the evaluations of disease activity in Crohn's disease

目的分析血浆抗凝血酶Ⅲ(AT-Ⅲ)活性和血清IL-6、降钙素原(PCT)在活动期与非活动期克罗恩病患者的水平差异及相关性,探讨三者对克罗恩病活动性的临床意义。方法回顾性分析克罗恩病患者62例临床资料,根据克罗恩病活动指数(CDAI)分为活动组(CDAI≥150分,n=32)和缓解组(CDAI<150分,n=30),30例健康人群为对照组,分别检测血浆AT-Ⅲ活性和血清IL-6、PCT水平,并分析其相关性。结果克罗恩病患者血浆AT-Ⅲ活性为(70.1±15.12)%,显著低于对照组(84.5±13.2)%(P<0.01),血清IL-6水平为73.55(26.6,113)ng/L,显著高于对照组1.2(0.5,3.1)ng/L(P<0.01),血清PCT水平为0.64(0.15,3.37)μg/L,显著高于对照组0.03(0.02,0.06)μg/L(P<0.01)。克罗恩病患者中,活动期患者血浆AT-Ⅲ活性为(59.45±13.24)%,显著低于缓解组(76.24±15.53)%(P<0.01),血清IL-6水平为65.23(53.3,155.38)ng/L,显著高于缓解组29.66(20.5,59.35)ng/L(P<0.01),血清PCT水平为8.4(2.6,19.2)μg/L,显著高于缓解组0.29(0.13,1.20)μg/L(P<0.05)。克罗恩病患者活动组中AT-Ⅲ活性与IL-6和PCT水平均呈明显负相关(r=-0.389,r=-0.317,P<0.01),缓解组中AT-Ⅲ活性与IL-6和PCT水平均呈明显负相关(r=-0.308,r=-0.279,P<0.05)。结论联合检测血浆AT-Ⅲ活性和血清IL-6、PCT水平有助于克罗恩病患者疾病活动性的判断。

Objective This study was undertaken to investigate the relationship between the levels of plasma AT-Ⅲ, serum IL-6, PCT and Crohn′s disease patients. The study explored their clinical significance from inflammatory cytokines and coagulation system, and evaluate the activity in Crohn′s disease.Methods The levels of AT-Ⅲ,IL-6 and PCT were tested in 62 Crohn′s disease patients which was divided into two groups. The correlation analyses were performed.Results The level of AT-Ⅲ in Crohn′s disease patients was significantly lower than the level in healthy people [（70.1±15.12）% vs （84.5±13.2）%, P〈0.01]. On the contrary, the levels of IL-6 and PCT in Crohn′s disease patients were significantly higher than the level in healthy people [73.55（26.6,113）ng/L vs 1.2（0.5,3.1）ng/L, 0.64（0.15,3.37）μg/L vs 0.03（0.02,0.06） μg/L, P〈0.01]. The level of AT-Ⅲ in the activity group was significantly lower than the level in the remission group [（59.45±13.24）% vs （76.24±15.53）%, P〈0.01], the level of IL-6 in the activity group was significantly higher than the level in the remission group [65.23（53.3, 155.38）ng/L vs 29.66（20.5, 59.35）ng/L, P〈0.01],also the level of PCT in the activity group was significantly higher than the level in the remission group[8.4（2.6, 19.2）μg/L vs 0.29（0.13, 1.20）μg/L, P〈0.05]. In Crohn′s disease patients active group, AT-III level significantly negatively correlates with IL-6 and PCT levels （r=-0.389, r=-0.317, P〈0.01）. AT-III level also significantly negatively correlates with IL-6 and PCT levels （r=-0.308, r=-0.279, P〈0.05） in the remission group.Conclusion In Crohn′s disease patients, the level of AT-III is well-correlated with IL-6 and PCT. The combined detection of plasma AT-III activity and the levels of serum IL-6 and PCT can contribute to early diagnosis of Crohn’s disease and the judgement of the disease activity.