粪便S100A12,钙卫蛋白和乳铁蛋白对溃疡性结肠炎患者疾病活动度和黏膜愈合评估价值分析

Evaluation Value of Stool S100A12,Fecal Calprotectin and Lactoferrin for Disease Activity and Mucosal Healing in Patients with Ulcerative Colitis

目的分析粪便S100A12,钙卫蛋白(fecal calprotectin,FC)和乳铁蛋白(lactoferrin,LF)对溃疡性结肠炎(ulcerative colitis,UC)患者疾病活动度和黏膜愈合情况的评估价值。方法选取2018年9月~2020年7月期间营口市中心医院收治的UC患者125例,根据疾病活动度将其分为缓解组(72例)和活动组(53例),缓解组再根据黏膜情况分为黏膜愈合组(34例)和黏膜病变组(38例)。检测所有患者的粪便S100A12,FC和LF水平,采用Pearson法分析粪便S100A12,FC,LF与UC镜下严重程度指数(UCEIS评分)的相关性,采用受试者操作特征曲线(ROC)分析粪便S100A12,FC和LF对UC患者疾病活动度和黏膜愈合的评估价值。结果活动组的粪便S100A12(1.21±0.36μg/g),FC(326.38±153.54μg/g)和LF(288.62±164.84μg/g)水平均明显高于缓解组(0.75±0.24μg/g,138.52±63.28μg/g,103.25±45.63μg/g),差异有统计学意义(t=8.566~9.367,均P<0.05);黏膜病变组的粪便S100A12(0.99±0.29μg/g),FC(188.94±70.94μg/g)和LF(142.31±63.21μg/g)水平明显高于黏膜愈合组(0.48±0.21μg/g,82.17±33.61μg/g,59.56±20.52μg/g),差异均有统计学意义(t=7.295~8.458,均P<0.05)。经Pearson分析显示,UC患者的粪便S100A12,FC,LF水平与UCEIS评分均呈正相关(r=0.426,0.438,0.417,均P<0.05);ROC分析显示,粪便S100A12,FC,LF对UC患者疾病活动度和黏膜愈合有一定的评估价值,且三者联合应用可有效提升评估价值,评估疾病活动度的曲线下面积为0.895,敏感度和特异度分别为88.70%和90.28%,评估黏膜愈合的曲线下面积为0.890,敏感度和特异度分别为91.18%和86.84%。结论粪便S100A12,FC和LF联合应用对UC患者疾病活动度和黏膜愈合的评估价值较高,具有一定的临床应用价值。

Objective To analyze the value of stool S100A12,fecal calprotectin(FC)and lactoferrin(LF)in the evaluation of disease activity and mucosal healing in patients with ulcerative colitis(UC).Methods 125 patients with UC admitted to Yingkou Central Hospital from September 2018 to July 2020 were selected,and they were divided into remission group(72 cases)and active group(53 cases)according to disease activity.The remission group was further divided into mucosal healing group(34 cases)and mucosal lesion group(38 cases)according to the mucosal condition.The levels of stool S100A12,FC and LF in all patients were detected.Pearson method was used to analyze the correlation between stool S100A12,FC,LF and UC microscopic severity index(UCEIS score).Receiver operating characteristic curve(ROC)was used to analyze the evaluation value of stool S100A12,FC and LF for disease activity and mucosal healing of patients with UC.Results The levels of stool S100A12(1.21±0.36μg/g),FC(326.38±153.54μg/g)and LF(288.62±164.84μg/g)in the active group were significantly higher than those in the remission group(0.75±0.24μg/g,138.52±63.28μg/g,103.25±45.63μg/g),the differences were statistically significant(t=8.566~9.367,all P<0.05).The levels of stool S100A12(0.99±0.29μg/g),FC(188.94±70.94μg/g)and LF(142.31±63.21μg/g)in the mucosal lesion group were significantly higher than those in the mucosal healing group(0.48±0.21μg/g,82.17±33.61μg/g,59.56±20.52μg/g),and the difference were statistically significant(t=7.295~8.458,all P<0.05).Pearson analysis showed that the levels of stool S100A12,FC and LF in patients with UC were positively correlated with the UCEIS score(r=0.426,0.438,0.417,all P<0.05).ROC analysis showed that stool S100A12,FC and LF had certain evaluation value for disease activity and mucosal healing of patients with UC,and the combined application of the three could effectively improve the evaluation value,the area under the curve for assessing disease activity was 0.895,the sensitivity and specificity were 88.70%and 90.28%,respectively.The area under the curve for assessing mucosal healing was 0.890,and the sensitivity and specificity were 91.18%and 86.84%,respectively.Conclusion Stool S100A12,FC and LF combined application of disease activity and mucosal healing in patients with UC have a high evaluation value,and it has a certain clinical application value.