FCP、MPO、ESR、CRP评价溃疡性结肠炎活动度的应用价值分析

The value of FCP, MPO, ESR and CRP in evaluating disease activity in ulcerative colitis

目的研究粪便钙卫蛋白(FCP)、髓过氧化物酶(MPO)、红细胞沉积率(ESR)及C反应蛋白(CRP)在溃疡性结肠炎(UC)活动度评价中的应用价值。方法回顾性分析本院2016年10月至2018年10月120例UC患者临床资料,根据改良Mayo评分系统将患者分为临床缓解组、轻度组、中度组及重度组。比较四组患者粪便FCP、MPO及血清ESR、CRP水平,分析FCP、MPO、ESR及CRP判断UC活动度重度与否的价值。结果四组间血清CRP、ESR及粪便MPO和FCP水平比较,差异均有统计学意义(均P<0.05)。重度组CRP水平高于其余三组、余三个指标水平均高于临床缓解组与轻度组,中度组上述四个指标水平均高于临床缓解组与轻度组,轻度组上述四个指标水平均高于临床缓解组,差异均有统计学意义(均P<0.05)。在ROC分析中,CRP、ESR、MPO及FCP各项指标判断UC活动度重度与否AUC分别为0.969、0.807、0.891、0.921(95%CI分别为0.931~1.000、0.719~0.895、0.831~0.952、0.879~0.979,均P<0.001)。结论采用血清ESR水平和粪便MPO、FCP水平评估患者是否处于重度活动度具有良好的预测价值,不同疾病活动度的患者CRP、ESR、MPO及FCP水平存在不同程度的差异。

Objective To investigate the value of fecal calprotectin (FCP), myeloperoxidase (MPO), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in evaluating disease activity in patients with ulcerative colitis. Methods This was a retrospective analysis of 120 patients with ulcerative colitis admitted to our hospital between October 2016 and October 2018. Pa. tients were divided into clinical remission, mild, moderate, and severe group according to the modified Mayo Score for Ulcerative Colitis. We compared the levels of FCP, MPO, ESR, and CRP beteen the four groups and analyzed their value in evaluating whether the patients are in severe activity or not. Results There were significant between-group differences in serum levels of CRP, ESR and levels of MPO and FCP in feces. CRP was significantly higher in severe group than in the other three groups, while MPO, FCP, and ESR were significantly higher in severe group than in remission and mild groups (P < 0.05). In the mod. erate group, MPO, FCP, ESR, and CRP were significantly higher in remission and mild group (P < 0.05). All the four markers were significantly higher in mild group than in remission group (P < 0.05). Using ROC analysis, areas under the curve were 0.969, 0.807, 0.891, and 0.921 in assessing severe activity in ulcerative colitis for CRP, ESR, MPO, and FCP, respectively (with 95%CI was 0.931~1.000, 0.719~0.895, 0.831~0.952, 0.879~0.979, respectively, all P < 0.001). Conclusion The levels of serum ESR, the levels of fecal MPO and FCP could be used to evaluate whether the patients are in severe activity or not, there were differences in the levels of CRP, ESR, MPO and FCP among patients with different disease activity.