溃疡性结肠炎内镜下活动度的影响因素分析及其与FGF21表达水平的关系探究

Analysis of influencing factors of endoscopic activity in ulcerative colitis and its relationship with FGF21 expression

目的探究成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)表达水平与溃疡性结肠炎(ulcerative colitis,UC)内镜活动度的关系。方法选择2018年6月至2020年6月于我院就诊的92例UC患者作为研究对象,根据UC内窥镜严重程度指数(UC endoscopic index of severity,UCEIS)评分将UC患者分为UC缓解期组(33例)和UC活动期组(59例),另选取同期于我院进行体检的健康人群作为对照组,比较三组的临床资料;再将UC活动期组患者分为轻中度活动UC组(46例)和重度活动UC组(13例),比较两组患者的临床资料;采用Pearson检验分析活动期UC患者FGF21与其他临床指标的相关性;多因素Logistic回归分析影响活动期UC及重度活动UC的因素;ROC曲线分析FGF21对活动期UC和重度活动UC患者的预测价值。结果对照组、UC缓解期组和UC活动期组患者的BMI、Treg依次降低,UCEIS评分、WBC、ESR、CRP、PLT、FGF21、Th17、Th17/Treg依次升高,组间差异均有统计学意义(P<0.05);重度活动UC组患者的BMI明显低于轻中度活动UC组患者,UCEIS评分、WBC、ESR、CRP、PLT、FGF21、Th17、Treg、Th17/Treg明显高于轻中度活动UC组患者(P<0.05);活动期UC患者的FGF21分别与BMI、Treg呈负相关,与UCEIS评分、WBC、ESR、CRP、PLT、Th17、Th17/Treg呈正相关(P<0.05);多因素Logistic回归分析结果显示,WBC、ESR、CRP、PLT、FGF21、Th17/Treg升高是活动期UC及重度活动UC的独立危险因素(P<0.05);FGF21预测活动期UC和重度活动UC的ROC曲线下面积分别为0.869和0.853。结论FGF21与UC的内镜下分期密切相关,且能够反映UC的活动度,具有较高的预测价值。

Objective To explore the relationship between the expression of fibroblast growth factor 21(FGF21)and the endoscopic activity of ulcerative colitis(UC).Methods 92 patients with UC who were treated in our hospital from Jun.2018 to Jun.2020 were selected as subjects.According to the UC endoscopic index of severity(UCEIS)score,UC patients were divided into UC remission group(n=33)and UC active group(n=59).Healthy people who underwent physical examination in our hospital in the same period were selected as the control group.The clinical data of the 3 groups were compared.The patients with active UC were divided into mild to moderate active UC group(n=46)and severe active UC group(n=13),and the clinical data of the 2 groups were compared.Pearson test was used to analyze the correlation between FGF21 and other clinical indexes in patients with active UC.Multivariate Logistic regression analysis was used to analyze the factors affecting active UC and severe active UC.ROC curve was used to analyze the predictive value of FGF21 in patients with active UC and severe active UC.Results The BMI and Treg of the patients in the control group,UC remission group and UC active group decreased in turn,while the UCEIS score,WBC,ESR,CRP,PLT,FGF21,Th17 and Th17/Treg of patients increased in turn(P<0.05).The BMI of patients with severe active UC was significantly lower than those of patients with mild to moderate active UC,while the scores of UCEIS,WBC,ESR,CRP,PLT,FGF21,Th17,Treg and Th17/Treg were significantly higher than those of patients with mild to moderate active UC(P<0.05).FGF21 in patients with active UC was negatively correlated with BMI and Treg,respectively,and positively correlated with UCEIS score,WBC,ESR,CRP,PLT,Th17,Th17/Treg(P<0.05).Multivariate Logistic regression analysis showed that the elevated levels of WBC,ESR,CRP,PLT,FGF21 and Th17/Treg were independent risk factors for active UC and severe active UC(P<0.05),and the areas under the ROC curve of active UC and severe active UC predicted by FGF21 were 0.869 and 0.853,respectively.Conclusion FGF21 is closely related to the endroscopic staging of UC,and can reflect the activity of UC,so it has high predictive value.