溃疡性结肠炎患者血清PTX3TFPI表达情况及其临床意义

Changes and clinical significance of serum PTX3 and TFPI levels in patients with ulcerative colitis

目的探讨溃疡性结肠炎(UC)患者血清正五聚蛋白3(PTX3)、组织因子途径抑制物(TFPI)表达情况及其临床意义。方法选择2020年7月至2022年5月华北理工大学附属医院收治的157例UC患者作为观察组,根据治疗前Mayo评分将其分为缓解期组(Mayo评分0~2分,n=62)和活动期组(Mayo评分≥3分,n=95)。活动期患者根据病情,分为轻度组32例、中度组40例和重度组23例;根据患者预后情况,将观察组分为好转组(n=108)例和未好转组(n=49),采用酶联免疫吸附法(ELISA)检测治疗前后血清PTX3、TFPI水平;ROC曲线分析治疗前血清PTX3、TFPI对UC患者临床治疗后未好转的诊断价值。结果治疗前,缓解期组血清PTX3水平为(8.56±2.35)ng/mL,TFPI为(85.42±9.62)ng/mL,低于活动期组,差异有统计学意义(P<0.05);缓解期组与活动期组患者治疗前后PTX3差值比较,差异有统计学意义(P<0.05);活动期中度组、重度组患者治疗前血清水平高于轻度组,重度组患者治疗前血清PTX3、TFPI水平高于中度组,差异有统计学意义(P<0.05);未好转组UC患者治疗前血清PTX3水平高于好转组,差异有统计学意义(P<0.05);治疗前血清PTX3、TFPI单独及联合诊断UC患者未好转的曲线下面积分别为0.830(95%CI=0.762~0.885)、0.819(95%CI=0.749~0.876)和0.907(95%CI=0.851~0.948)。结论UC患者血清PTX3、TFPI升高,与患者病情严重程度和预后有关,可能作为UC患者病情评估与疗效评价的标志物。

Objective To investigate the expression of positive pentameric protein 3(PTX3)and tissue factor pathway inhibitor(TFPI)in serum of patients with ulcerative colitis(UC)and its clinical significance.Methods A total of 157 UC patients admitted to the Affiliated Hospital of North China University of Science and Technology from July 2020 to May 2022 were selected as the observation group.They were divided into the remission group(Mayo score 0~2,n=62)and the active group(Mayo score≥3,n=95)according to Mayo scores.Active patients were divided into a mild group(32 cases),a moderate group(40 cases),and a severe group(23 cases)according to their condition.According to the prognosis of patients,the observation group was divided into an improved group(n=108)and a non-improved group(n=49).Enzyme-linked immunosorbent assay(ELISA)was used to detect the serum PTX3 and TFPI levels before and after treatment.ROC curve was performed to analyze the diagnostic value of serum PTX3 and TFPI before treatment in patients with UC who did not improve after clinical treatment.Results Before treatmentthe serum PTX3 and TFPI levels in the remission stage group were(8.56±2.35)ng/mL and(85.42±9.62)ng/mL respectively,which were lower than those in the active stage group respectively,with statistically significant differences(P<0.05).The difference in PTX3,TFPI before and after treatment between the remission group and the active group was statistically significant(P<0.05).During the active period,the serum levels of PTX3,TFPI in the moderate and severe groups before treatment were higher than those in the mild group.The serum levels of PTX3 and TFPI in the severe group before treatment were higher than those in the moderate group,and the difference was statistically significant(P<0.05).The serum levels of PTX3 and TFPI in UC patients in the non improvement group were higher than those in the improvement group,and the difference was statistically significant(P<0.05).The areas under the curve of untreated patients with UC diagnosed by serum PTX3 and TFPI alone and in combination before treatment were 0.830(95%CI=0.762~0.885),0.819(95%CI=0.749~0.876),and 0.907(95%CI=0.851~0.948),respectively.Conclusions The serum levels of PTX3 and TFPI increase in UC patients,which is related to the severity and prognosis of the patients,and may be used as markers for the evaluation of the disease and efficacy of UC patients.