血清IL-33、粪便钙卫蛋白水平在溃疡性结肠炎中的表达及对复发的预测

Expression Levels of Serum IL-33 and Fecal Calprotectin in Ulcerative Colitis and Prediction of Recurrence

目的:探究血清白介素-33(IL-33)和粪便钙卫蛋白在溃疡性结肠炎中的表达和对预后复发的预测。方法:选取2019年12月至2022年1月在本院收治的113例溃疡性结肠炎患者作为研究参与者,依据溃疡性结肠炎分期分为活动期70例、缓解期43例,按严重程度分为重度33例、中度39例、轻度41例,依据溃疡性结肠炎患者预后复发情况分为复发组38例、未复发组为75例,选择110名同期体检健康者作为对照组;比较血清IL-33和粪便钙卫蛋白在溃疡性结肠炎患者以及对照组中的表达水平,分析血清IL-33和粪便钙卫蛋白对复发溃疡性结肠炎患者的预测价值。结果:对照组中血清IL-33和粪便钙卫蛋白表达水平明显低于活动期组和缓解期组(P<0.05),活动期组中血清IL-33和粪便钙卫蛋白表达水平明显高于缓解期组(P<0.05);轻度组中血清IL-33和粪便钙卫蛋白表达水平明显低于重度组和中度组(P<0.05);中度组中血清IL-33和粪便钙卫蛋白表达水平明显低于重度组(P<0.05);未复发组溃疡性结肠炎患者的血清IL-33和粪便钙卫蛋白表达水平明显低于复发组(P<0.05)。ROC曲线分析显示,血清IL-33、粪便钙卫蛋白AUC分别为0.714、0.623时,约登指数最大,其截断值分别为130.03、517.68时,联合预测AUC为0.827(95%CI:0.737~0.918)、灵敏度为77.4%、特异度为79.3%、阳性预测值78.9%、阴性预测值77.8%均高于各参数单项检验(P<0.05),预测效能最佳。结论:血清IL-33与粪便钙卫蛋白的表达水平与溃疡性结肠炎患者的病情活动程度与预后情况密切相关,可作为临床诊断和预测溃疡性结肠炎的生物标志物。

Objective To investigate the expression levels of serum interleukin-33(IL-33)and fecal cal-protectin in ulcerative colitis and to predict the prognosis of recurrence.Methods A total of 113patients with ulcerative colitis admitted to our hospital from December 2019to January 2022were selected as the study participants.According to the stage of ulcerative colitis,70cases were in active stage,and 43cases were in remission stage.According to the severity,there were 33severe cases,39 moderate cases,and 41 mild cases.According to the recurrence prognosis of patients with ulcerative colitis,they were divided into the recurrence group(38cases)and the non-recurrence group(75cases).Total 110healthy subjects were selected as the control group.The expression levels of serum IL-33and fecal calprotectin in patients with ulcerative colitis and the control group were compared,and the predictive value of serum IL-33and fecal calprotectin in patients with recurrent ulcerative colitis was analyzed.Results The expression levels of serum IL-33and fecal calprotectin in the control group were significantly lower than those in the active stage group and remission stage group(P<0.05).The expression levels of serum IL-33and fecal calpro-tectin in the active stage group were significantly higher than those in the remission stage group(P<0.05).The expression levels of serum IL-33and fecal calprotectin in the mild group were significantly low-er than those in the severe group and moderate group(P<0.05).The expression levels of serum IL-33 and fecal calprotectin in the moderate group were significantly lower than those in the severe group(P<0.05).The expression levels of serum IL-33and fecal calprotectin in the non-recurrence group were signifi-cantly lower than those in the recurrence group(P<0.05).ROC curve analysis showed that when the AUC of serum IL-33and fecal calprotectin were 0.714and 0.623,respectively,the Joden index was the lar-gest.When the cutoff values were 130.03and 517.68,respectively,the combined prediction AUC was 0.827(95%CI:0.737~0.918),sensitivity(77.4%),specificity(79.3%),positive predictive value(78.9%),negative predictive value(77.8%),which were higher than the single test of each parameter(P<0.05),and the prediction efficiency was the best.Conclusion The expression levels of serum IL-33 and fecal calprotectin are closely related to the disease activity level and prognosis of patients with ulcera-tive colitis,which can be used as biomarkers for clinical diagnosis and prediction of ulcerative colitis.