克罗恩病患者血清D-乳酸和二胺氧化酶在病情评估中的价值

The value of serum D-lactic acid and diamine oxidase in patients with Crohn's disease

目的探讨D-乳酸(D-LA)和二胺氧化酶(DAO)作为克罗恩病(CD)患者疾病活动生物标志物的价值。方法选取2017年3月~2019年2月就诊于解放军联勤保障部队第九〇四医院的54例CD患者和同期就诊的25名健康体检者。分别检测血清中D-LA和DAO的水平,分析D-LA和DAO等因子与克罗恩病活动性的相关性,并通过ROC曲线检验其诊断价值。结果54例CD患者,其中26例为活动期、28例为缓解期。活动期和缓解期CD患者外周血D-LA浓度分比为(16.02±4.6)mg/L和(11.18±3.14)mg/L,两组间差异有统计学意义(P<0.001)。活动期和缓解期CD患者外周血DAO活性分比为(11.04±4.45)U/L和(7.72±3.42)U/L,两组间差异有统计学意义(P<0.001)。CD患者外周血D-LA(r=0.68,P<0.05)和DAO(r=0.53,P<0.05)均与克罗恩病疾病活动指数(CDAI)正相关。D-LA诊断疾病活动性的曲线下面积(AUC)为0.813,DAO诊断疾病活动性的AUC为0.747,联合D-LA、DAO、ESR、CRP的AUC为0.863。结论外周血D-LA和DAO对CD疾病活动性具有较高的诊断价值,与目前常用的生物标志物如CRP和ESR联合应用,可显著提高对CD疾病活动性的诊断准确性。

Objective To explore the value of D-lactic acid(D-LA)and diamine oxidase(DAO)as biomarkers of disease activity in patients with Crohn's disease(CD).Methods From March 2017 to February 2019,54 cases of CD patients and 25 healthy persons in our hospital were selected.The levels of D-LA and Dao in plasma were detected,and the correlation between D-LA and Dao and the activity of Crohn's disease was analyzed,The diagnostic value was tested by ROC curve.Results Among 54 patients with CD,26 were active and 28 were remission.The ratio of D-LA concentration in active and remission CD patients was(16.02±4.6)mg/L and(11.18±3.14)mg/L,with significant difference between the two groups(P<0.001).The ratio of Dao activity in active and remission CD patients was(11.04±4.45)U/L and(7.72±3.42)U/L,with significant difference between the two groups(P<0.001).D-LA(r=0.68,P<0.05)and DAO(r=0.53,P<0.05)were positively correlated with CDAI in CD patients.The AUC of D-LA,DAO,ESR and CRP was 0.813,0.747,0.863,respectively.Conclusion Peripheral blood D-LA and DAO have high diagnostic value for CD disease activity.Combined with the commonly used biomarkers such as CRP and ESR,it can significantly improve the diagnostic accuracy of CD disease activity.