血清钙卫蛋白在炎症性肠病诊断中的应用价值

The value of serum calprotectin in the diagnosis of inflammatory bowel disease

目的探讨血清钙卫蛋白(CALP)在炎症性肠病(IBD)诊断中的临床价值。方法采用ELISA法检测IBD、普通腹泻组及正常对照组血清中CALP的含量,并与白细胞、血沉、C-反应蛋白的结果比较。结果UC、CD活动期CALP水平高于普通腹泻组和正常对照组,差异有统计学意义(P<0.05)。UC、CD缓解期CALP水平与普通腹泻组和正常对照组比较,差异无统计学意义(P>0.05)。UC、CD活动期与缓解期的CALP水平比较差异有统计学意义(P<0.05)。CALP水平在7例IBD患者治疗前后比较,差异有统计学意义(t=4.449,P<0.05)。UC组的CALP水平与WBC、ESR、CRP呈正相关(r=0.629,r=0.483,r=0.397,P<0.05);CD组的CALP水平与WBC呈正相关(r=0.346,P<0.05),与CRP、ESR无相关性(r=0.038,r=-0.041,P>0.05)。CD组CALP为42.442 pg/ml时,AUC为0.888,灵敏度为88.2%,特异度为76.7%。UC组CALP为76.252 pg/ml时,AUC为0.961,灵敏度为88.2%,特异度为100%。结论血清CALP在诊断炎症性肠病及其活动性有一定意义,特别是对UC的活动期诊断价值更高。

Objective To investigate the clinical value of calprotectin in inflammatory bowel disease(IBD).Methods The calprotectin levels in the serum of inflammatory bowel disease patients,common diarrhea patients and healthy physical examination people were detected by ELISA,which was compared with the results of leukocyte,erythrocyte sedimentation rate and C-reactive protein.Results The levels of calprotectin in the active stage of UC and CD were slightly higher than those in the common diarrhea patients and the people for physical examination,with the differences statistically significant(P<0.05).CALP levels in remission stage of UC and CD were not significantly different from those in normal diarrhea group and the control group(P>0.05).There was statistical significance on the differences in CALP levels between the active stage of UC and CD and those in remission stage(P<0.05).CALP level in 7 IBD patients before and after treatment was statistically significant(t=4.449,P<0.05).CALP level in UC group was positively correlated with WBC,ESR and CRP(r=0.629,r=0.483,r=0.397,P<0.05);CALP level in CD group was positively correlated with WBC(r=0.346,P<0.05),but had no correlation with CRP and ESR(r=0.038,r=0.041,P>0.05).When CALP was 42.442 pg/ml in CD group,AUC was 0.888,sensitivity was 88.2%,and specificity was 76.7%.When CALP was 76.252 pg/ml in UC group,AUC was 0.961,sensitivity was88.2%,and specificity was 100%.Conclusion The level of calprotectin in serum had certain significance for the diagnosis of inflammatory bowel disease and in the active stage of UC disease,and calprotectin had higher diagnostic value.