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Epidemiological,clinical,and histological presentation of celiac disease in Northwest China 被引量:1
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作者 Man Wang Wen-Jie Kong +8 位作者 Yan Feng Jia-Jie Lu Wen-Jia Hui Wei-Dong liu zi-qiong li Tian Shi Mei Cui Zhen-Zhu Sun Feng Gao 《World Journal of Gastroenterology》 SCIE CAS 2022年第12期1272-1283,共12页
BACKGROUND Research on celiac disease(CD)in northwest China is still in its infancy.At present,large-sample data on the epidemiological,clinical,and pathological characteristics of CD are limited.AIM To investigate th... BACKGROUND Research on celiac disease(CD)in northwest China is still in its infancy.At present,large-sample data on the epidemiological,clinical,and pathological characteristics of CD are limited.AIM To investigate the epidemiological,clinical,and pathological characteristics of CD in northwest China.METHODS The clinical data of 2884 patients with gastrointestinal(GI)symptoms were retrospectively analyzed.Total immunoglobulin A(IgA)and anti-tissue transglutaminase(tTG)IgA levels were examined in all patients.Gastroscopy and colonoscopy were performed in patients with positive anti-tTG IgA and deficient total IgA levels.Atrophy of the duodenal and ileal villi was examined and histopathological examinations were performed.The modified Marsh–Oberhuber classification system was used to grade villous atrophy in the duodenum or distal ileum.The patients’Helicobacter pylori(H.pylori)infection status was compared in terms of clinical presentation and Marsh grade.Statistical analyses were performed using the t-test or chi-square test.RESULTS Among the 2884 patients,73 were positive for serum anti-tTG IgA,and 50 were diagnosed with CD.The CD detection rate was significantly higher in Kazakhs(4.39%)than in Uyghurs(2.19%),Huis(0.71%),and Hans(0.55%).The main symptoms of CD were chronic diarrhea,anorexia,anemia,fatigue,weight loss,sleep disorders,osteopenia,and osteoporosis.The body mass index of patients with CD was significantly lower than that of patients without CD.A total of 69 patients with positive serum anti-tTG IgA and two patients with deficient total IgA levels underwent GI endoscopy.Endoscopy revealed crypt hyperplasia and/or duodenal villous atrophy,mainly manifested as nodular mucosal atrophy,grooves,and fissures.The difference in H.pylori infection rates was not statistically significant between CD and non-CD patients but was significantly different among CD patients with different Marsh grades.CONCLUSION Among the patients with GI symptoms in northwestern China,the prevalence of CD was more in the Uyghur and Kazakh populations.H.pylori infection may be associated with CD severity. 展开更多
关键词 Celiac disease EPIDEMIOLOGY Gastrointestinal symptoms PATHOLOGY Helicobacter pylori infection
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粪便CHI3L1对溃疡性结肠炎镜下活动和病情严重程度的预测价值 被引量:7
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作者 卢加杰 刘晶 +4 位作者 李紫琼 冯燕 孔文洁 木尼拉·买买提 高峰 《中国现代医学杂志》 CAS 北大核心 2021年第11期60-64,共5页
目的探讨粪便几丁质酶3样蛋白1(CHI3L1)对溃疡性结肠炎镜下活动和病情严重程度的预测价值。方法采用病例对照研究,比较2017年3月—2019年5月就诊的183例溃疡性结肠炎患者和健康对照者粪便CHI3L1的差异,分析粪便CHI3L1与溃疡性结肠炎Seo.... 目的探讨粪便几丁质酶3样蛋白1(CHI3L1)对溃疡性结肠炎镜下活动和病情严重程度的预测价值。方法采用病例对照研究,比较2017年3月—2019年5月就诊的183例溃疡性结肠炎患者和健康对照者粪便CHI3L1的差异,分析粪便CHI3L1与溃疡性结肠炎Seo.m临床活动指数(Seo.m CAI)和溃疡性结肠炎镜下严重程度指数(UCEIS)的相关性,绘制受试者工作特征(ROC)曲线分析粪便CHI3L1水平,预测UC镜下活动和病情严重程度的准确性,确定最佳诊断分界点及诊断的敏感性和特异性。结果溃疡性结肠炎患者粪便CHI3L1水平75.91(17.25,834.72)ng/ml高于健康对照者5.17(3.18,16.45)ng/ml(P <0.05)。溃疡性结肠炎患者临床活动性评估,Seo.m CAIⅠ级、Ⅱ级和Ⅲ级3组粪便CHI3L1差异有统计学意义(P <0.05);镜下活动性评估,UCEIS镜下缓解、轻-中度活动和重度活动3组粪便CHI3L1水平差异有统计学意义(P <0.05)。溃疡性结肠炎患者粪便CHI3L1水平与Seo.m CAI和UCEIS呈正相关(r_(s)=0.580和0.760,均P <0.05)。粪便CHI3L1水平预测溃疡性结肠炎镜下活动和重度溃疡性结肠炎的ROC曲线下面积分别为0.929 (95%Cl:0.877,0.974)和0.908 (95%Cl:0.842,0.965)。当粪便CHI3L1>15.28 ng/ml时对诊断溃疡性结肠炎镜下活动具有较高的准确性,敏感性和特异性分别为93.25%(95%Cl:0.895,0.992)和86.39%(95%Cl:0.787,0.914);当粪便CHI3L1>112.45 ng/ml时对诊断UC重度活动具有较高的准确性,敏感性和特异性分别为87.92%(95%Cl:0.802,0.937)和75.13%(95%Cl:0.674,0.863)。结论粪便CHI3L1是溃疡性结肠炎镜下活动和重度病情较好的预测指标,在溃疡性结肠炎患者肠道炎症程度评估中具有较高的临床应用价值,是便捷、可靠的非侵入性检查手段之一。 展开更多
关键词 溃疡性结肠炎 几丁质酶3样蛋白1 粪便炎症标志物 内镜评分
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