克罗恩病患者血清淀粉样蛋白A与内镜评分的相关性分析

Correlation of serum amyloid A level with endoscopic score in patients with Crohn s disease

目的 探讨血清淀粉样蛋白A(serum amyloid A, SAA)与克罗恩病(Crohn’s disease, CD)患者内镜评分的相关性。方法 选取同济大学附属第十人民医院2021年1月—2022年2月收治的103例CD患者,检测所有患者SAA、C反应蛋白(C-reactive protein, CRP)、红细胞沉降率(erythrocyte sedimentation rate, ESR)、白介素-6(interleukin-6, IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)及白介素-1β(interleukin-1β, IL-1β)浓度,所有患者均进行结肠镜检查并行CD简化内镜评分(simple endoscopic score in CD, SES-CD),探讨各炎症指标与SES-CD的相关性。结果 SAA、CRP、ESR、IL-6、TNF-α浓度与SES-CD评分均呈正相关,相关系数(rs)分别为0.585、0.552、0.400、0.297、0.208,均P<0.05,IL-1β浓度与SES-CD无相关性;SAA、CRP、ESR预测SES-CD的曲线下面积值(AUC)分别为0.809、0.766、0.721,均P<0.001。结论 与其他炎症指标相比,SAA能够更好地预测CD患者黏膜愈合情况,尤其适用于经济能力有限或内镜检查依从性差的反复复发的CD患者疾病活动性的评估,值得临床推广应用。

Objective To investigate the correlation of serum amyloid A(SAA)level with endoscopic score in patients with Crohn s disease.Methods A total of 103 CD patients admitted to Shanghai Tenth People s Hospital from January 2021 to February 2022 were recruited.The serum levels of SAA,C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and erythrocyte sedimentation rate(ESR)were measured.All patients underwent colonoscopy and evaluated with CD simplified endoscopic score(SES-CD),the correlation of serum indicators with SES-CD was analyzed.Results The serum levels of SAA,CRP,IL-6,TNF-αand ESR were positively correlated with SES-CD scores,the Spearman s rank correlation coefficients(r s)were 0.585,0.552,0.297,0.208,0.400,respectively(all P<0.05);while of IL-1βlevel was not correlated with SES-CD.The area under the ROC curve(AUC)of SAA,CRP and ESR in predicting SES-CD were 0.809,0.766 and 0.721,respectively(all P<0.001).Conclusion Compared with other inflammatory indicators,SAA can better predict disease activity for CD patients,which is worthy of clinical promotion.