粪钙卫蛋白、血小板、D-二聚体及降钙素原与溃疡性结肠炎的相关性分析

Clinical values of fecal calprotectin, procalcitonin, platelets and D-dimers in diagnosis and severity assessment of ulcerative colitis

目的:探讨粪钙卫蛋白(FC)、血小板(PLT)、D-二聚体(D-D)及降钙素原(PCT)在评估溃疡性结肠炎(UC)活动性及严重程度中的临床价值。方法:选取126例UC患者,根据改良Mayo评分,分为缓解期组33例,活动期组93例,其中轻度活动组37例,中度活动组32例,重度活动组24例。比较各组患者之间的FC、PLT、D-D及PCT水平,同时绘制受试者工作特征曲线(ROC)来比较各指标独立及联合诊断重度UC的能力。结果:活动期组患者的FC、PLT、D-D及PCT均高于缓解期组,差异有统计学意义(P<0.05);活动期组患者随着UC严重程度升高,FC、PLT、D-D及PCT水平也相应升高,差异有统计学意义(P<0.05)。Spearman相关性分析显示,UC患者的FC、PLT、D-D及PCT水平与改良Mayo评分均呈正相关(P<0.05)。ROC曲线分析显示,FC、PCT、PLT及D-D诊断重度UC的ROC曲线下面积分别为0.929、0.888、0.829、0.763,最佳截断值分别为628.4μg/g、3.58 ng/mL、295.7×109/L、1.98 mg/L。各指标联合检测对于诊断重度UC均具有较好的价值,优于各指标独立检测。结论:FC、PLT、D-D及PCT在评估UC活动性及严重程度中具有较好的价值,各指标联合检测的诊断价值更高。

Objective: To investigate the clinical value of fecal calprotectin(FC), platelet(PLT), D-dimer(D-D) and procalcitonin(PCT) for the diagnosis and severity assessment in the patients of ulcerative colitis. Methods: 126 patients with ulcerative colitis were divided into active UC group and remission UC group according to the modified Mayo scoring system, and 37 cases were in mild group, 32 cases in moderate group, 24 cases in severe group. Compared the levels of FC, PLT, D-D and PCT between the active UC group and the remission UC group. The areas under the receiver operating characteristic(ROC) curve were calculated to verify the predictive value of each test index for the severe ulcerative colitis. Results: The levels of FC, PLT, D-D and PCT in active UC group were significantly higher than those in remission UC group(P<0.05). In the active UC group, the levels of FC, PLT, D-D and PCT increased with the severity of ulcerative colitis, and all differences were statistically significant(P<0.05). The levels of FC, PLT, D-D and PCT in patients with ulcerative colitis were positively correlated with the modified Mayo score(P<0.05). The areas under ROC curve of PLT, D-D, PCT and FC for the diagnosis of severe group were 0.829, 0.763, 0.888 and 0.929, and the cut-off values were 295.7×109/L, 1.98 mg/L, 3.58 ng/mL and 628.4 μg/g, respectively. And the combined detection of these indicators has a higher value for the diagnosis of severe UC. Conclusion: The levels of FC, PLT, D-D and PCT can be used in the diagnosis and severity assessment of ulcerative colitis.