活动期溃疡性结肠炎患者血清TSG-6、col-16水平与病情严重程度及临床结局的关系

Relationship between serum TSG-6 and col-16 levels and severity of the illness and clinical outcome in patients with active ulcerative colitis

目的 探讨活动期溃疡性结肠炎(UC)患者血清肿瘤坏死因子α刺激基因6(TSG-6)、ⅩⅥ型胶原蛋白(col-16)水平与病情严重程度及临床结局的关系。方法 选取2020年1月至2023年1月该院消化内科收治的79例活动期UC患者为活动期UC组,另选取同期该院收治的性别、年龄与活动期UC组相近的56例缓解期UC患者作为缓解期UC组,以及同期在该院体检的60例体检健康者作为对照组。根据改良的Mayo评分将活动期UC患者分为轻度组(n=25)、中度组(n=34)、重度组(n=20),活动期UC患者治疗2个月后根据结肠镜复查结果分为预后良好组(n=58)和预后不良组(n=21)。采用酶联免疫吸附试验法检测各组血清TSG-6、col-16水平,Spearman秩相关分析血清TSG-6、col-16水平与病情严重程度的关系,多因素Logistic回归分析血清TSG-6、col-16水平对临床结局的影响。受试者工作特征(ROC)曲线评估血清TSG-6、col-16对活动期UC患者预后不良的预测价值。结果 活动期UC组、缓解期UC组血清TSG-6、col-16水平高于对照组,且活动期UC组血清TSG-6、col-16水平高于缓解期UC组,差异有统计学意义(P<0.05)。重度组和中度组血清TSG-6、col-16水平高于轻度组,且重度组血清TSG-6、col-16水平高于中度组,差异均有统计学意义(P<0.05)。经Spearman秩相关分析,活动期UC患者血清TSG-6、col-16与改良的Mayo评分呈正相关(rs=0.695、0.627,P<0.05)。多因素Logistic回归分析结果显示,与<159.32 ng/mL比较,血清TSG-6四分位数间距分段为289.15~413.55 ng/mL、>413.55 ng/mL患者预后不良发生风险较高。ROC曲线分析结果显示,TSG-6、col-16预测预后不良的曲线下面积分别为0.776、0.764,血清TSG-6、col-16联合检测的预测价值优于单一指标(Z=3.392、4.218,P<0.05)。结论 活动期UC患者血清TSG-6、col-16水平异常升高,且与病情严重程度及临床结局密切相关,血清TSG-6、col-16水平可作为判断病情及预测临床结局的潜在生化指标。

Objective To investigate the relationship between serum tumor necrosis factorαstimulated gene 6(TSG-6)and collagenⅩⅥ(col-16)levels and severity of the illness and clinical outcome in patients with active ulcerative colitis(UC).Methods A total of 79 patients with active UC admitted to the department of gastroenterology in the hospital from January 2020 to January 2023 were selected as the active UC group,56 patients with UC in remission who were similar in gender and age to the active UC group were selected as the remission UC group,and 60 healthy subjects who underwent physical examination in the hospital during the same period were selected as the control group.Patients with active UC were divided into mild group(n=25),moderate group(n=34)and severe group(n=20)according to the modified Mayo score.Patients with active UC were divided into good prognosis group(n=58)and poor prognosis group(n=21)according to colonoscopy results after 2 months of treatment.Serum TSG-6 and col-16 levels in each group were detected by enzyme-linked immunosorbent assay,Spearman rank correlation analysis was used to analyze the relationship between serum TSG-6 and col-16 levels and severity of the illness,and the influence of serum TSG-6 and col-16 levels on clinical outcome was analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum TSG-6 and col-16 for poor prognosis in patients with active UC.Results The serum TSG-6 and col-16 levels in active UC group and remission UC group were higher than those in control group,and the serum TSG-6 and col-16 levels in active UC group were higher than those in remission UC group,the difference was statistically significant(P<0.05).Serum TSG-6 and col-16 levels in severe group and moderate group were higher than those in mild group,and serum TSG-6 and col-16 levels in severe group were higher than those in moderate group,with statistical significance(P<0.05).By Spearman rank correlation analysis,serum TSG-6 and col-16 in active UC patients were positively correlated with modified Mayo scores(r s=0.695、0.627,P<0.05).Multivariate Logistic regression analysis showed that compared with<159.32 ng/mL,patients with serum TSG-6 interquartile interval of 289.15-413.55 ng/mL and>413.55 ng/mL had a higher risk of poor prognosis.ROC curve analysis results showed that the area under the curve of TG-6 and col-16 in predicting poor prognosis was 0.776 and 0.764,respectively.The predictive value of serum TG-6 and col-16 combined detection was better than that of single index(Z=3.392,4.218,P<0.05).Conclusion The serum TSG-6 and col-16 levels in active UC patients are abnormally elevated,which is closely related to severity of the illness and clinical outcome.The levels of serum TSG-6 and col-16 can be used as potential biochemical indicators to judge the disease and predict the clinical outcome.