AIM： To evaluate fecal calprotectin （FC） as a surrogate marker of treatment outcome of relapse of inflammatory bowel disease （IBD） and, to compare FC with fecal myeloperoxidase （MPO） and fecal eosinophil protei...AIM： To evaluate fecal calprotectin （FC） as a surrogate marker of treatment outcome of relapse of inflammatory bowel disease （IBD） and, to compare FC with fecal myeloperoxidase （MPO） and fecal eosinophil protein X （EPX）. METHODS： Thirty eight patients with IBD, comprising of 27 with ulcerative colitis （UC） and 11 with Crohn＇s disease （CD） were investigated before treatment （inclusion）, and after 4 and 8 wk of treatment. Treatment outcomes were evaluated by clinical features of disease activity and endoscopy in UC patients, and disease activity in CD patients. In addition, fecal samples were analyzed for FC by enzyme-linked immunosorbent assay （ELISA）, and for MPO and EPX with radioimmunoassay （RIA）. RESULTS： At inclusion 37 of 38 （97%） patients had elevated FC levels （〉 94.7 μg/g）. At the end of the study, 31 of 38 （82%） patients fulfilled predefined criteria of a complete response IUC 21/27 （78%）; CD 10/11 （91%）]. Overall, a normalised FC level at the end of the study predicted a complete response in 100% patients, whereas elevated FC level predicted incomplete response in 30%. Normalised MPO or EPX levels predicted a complete response in 100% and 90% of the patients, respectively. However, elevated MPO or EPX levels predicted incomplete response in 23% and 22%, respectively. CONCLUSION： A normalised FC level has the potential to be used as a surrogate marker for successful treatment outcome in IBD patients. However, patients with persistent elevation of FC levels need further evaluation. FC and MPO provide superior discrimination than EPX in IBD treatment outcome.展开更多
AIM： To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis （UC）. METHODS： The enzyme-linked immunosorbent assay （ELISA） was used to measu...AIM： To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis （UC）. METHODS： The enzyme-linked immunosorbent assay （ELISA） was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, acid glycoprotein （AGP） were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria. RESULTS： The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls （402.16 ± 48.0 μg/g vs 35.93 ± 3.39 μg/g, 11.5 ± 3.42 μg/g, P 〈 0.01）. The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group （P 〈 0.05）. A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics （AUCR^c） was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP, respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC （r = 0.866, P 〈 0.001）. CONCLUSION： Calprotectin in the patient＇s feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonlyused markers such as CRP, ESR and AGP.展开更多
目的总结突发无痛性大量便血的卧床患者的临床资料,以期为临床诊治提供参考。方法本研究纳入分析的患者便血出血量大于400 m L,卧床时间为7 d及以上。本院2010年1月至2020年12月诊治的符合研究纳入条件的患者共45例,收集其临床资料,进...目的总结突发无痛性大量便血的卧床患者的临床资料,以期为临床诊治提供参考。方法本研究纳入分析的患者便血出血量大于400 m L,卧床时间为7 d及以上。本院2010年1月至2020年12月诊治的符合研究纳入条件的患者共45例,收集其临床资料,进行回顾性分析并按照出血原因的不同进行归类整理。结果粪性溃疡26例,包括19例多发溃疡、7例单发溃疡,患者平均年龄为(68.3±14.6)岁,中位卧床时间为12.0(9.0,19.3)d,使用抗凝、抗血小板药物的有12例。急性出血性直肠溃疡综合征(AHRUS)15例,包括6例多发溃疡、9例单发溃疡,患者平均年龄为(65.7±11.5)岁,中位卧床时间为10(8,17)d,使用抗凝、抗血小板药物的有7例。粪性溃疡、AHRUS患者采用电子结肠镜下钛夹夹闭止血、经肛门缝合结扎止血或(电子结肠镜下电凝后)凡士林纱布填塞压迫止血等方式处理后,出血完全控制。异物损伤2例,考虑原因分别为开塞露操作不当、灌肠操作,经肛门缝合结扎止血后出血得以控制。直肠憩室1例,予以蛇毒血凝酶灌肠、凡士林纱布填塞压迫止血后出血得以控制。直肠癌1例,予蛇毒血凝酶灌肠、凡士林纱布填塞压迫止血后症状好转,后由于直肠癌基础疾病,患者家属放弃进一步治疗,患者死亡。结论临床中应对突发无痛性大量便血予以足够重视,早期发现并积极处理对患者的临床转归具有重要的意义。对于老年卧床患者、合并严重基础疾病的卧床患者,要注意考虑粪性溃疡、AHRUS的可能。展开更多
基金Grants from the Medical Faculty, Uppsala University, Uppsala, Sweden
文摘AIM： To evaluate fecal calprotectin （FC） as a surrogate marker of treatment outcome of relapse of inflammatory bowel disease （IBD） and, to compare FC with fecal myeloperoxidase （MPO） and fecal eosinophil protein X （EPX）. METHODS： Thirty eight patients with IBD, comprising of 27 with ulcerative colitis （UC） and 11 with Crohn＇s disease （CD） were investigated before treatment （inclusion）, and after 4 and 8 wk of treatment. Treatment outcomes were evaluated by clinical features of disease activity and endoscopy in UC patients, and disease activity in CD patients. In addition, fecal samples were analyzed for FC by enzyme-linked immunosorbent assay （ELISA）, and for MPO and EPX with radioimmunoassay （RIA）. RESULTS： At inclusion 37 of 38 （97%） patients had elevated FC levels （〉 94.7 μg/g）. At the end of the study, 31 of 38 （82%） patients fulfilled predefined criteria of a complete response IUC 21/27 （78%）; CD 10/11 （91%）]. Overall, a normalised FC level at the end of the study predicted a complete response in 100% patients, whereas elevated FC level predicted incomplete response in 30%. Normalised MPO or EPX levels predicted a complete response in 100% and 90% of the patients, respectively. However, elevated MPO or EPX levels predicted incomplete response in 23% and 22%, respectively. CONCLUSION： A normalised FC level has the potential to be used as a surrogate marker for successful treatment outcome in IBD patients. However, patients with persistent elevation of FC levels need further evaluation. FC and MPO provide superior discrimination than EPX in IBD treatment outcome.
文摘AIM： To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis （UC）. METHODS： The enzyme-linked immunosorbent assay （ELISA） was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, acid glycoprotein （AGP） were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria. RESULTS： The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls （402.16 ± 48.0 μg/g vs 35.93 ± 3.39 μg/g, 11.5 ± 3.42 μg/g, P 〈 0.01）. The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group （P 〈 0.05）. A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics （AUCR^c） was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP, respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC （r = 0.866, P 〈 0.001）. CONCLUSION： Calprotectin in the patient＇s feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonlyused markers such as CRP, ESR and AGP.
文摘目的总结突发无痛性大量便血的卧床患者的临床资料,以期为临床诊治提供参考。方法本研究纳入分析的患者便血出血量大于400 m L,卧床时间为7 d及以上。本院2010年1月至2020年12月诊治的符合研究纳入条件的患者共45例,收集其临床资料,进行回顾性分析并按照出血原因的不同进行归类整理。结果粪性溃疡26例,包括19例多发溃疡、7例单发溃疡,患者平均年龄为(68.3±14.6)岁,中位卧床时间为12.0(9.0,19.3)d,使用抗凝、抗血小板药物的有12例。急性出血性直肠溃疡综合征(AHRUS)15例,包括6例多发溃疡、9例单发溃疡,患者平均年龄为(65.7±11.5)岁,中位卧床时间为10(8,17)d,使用抗凝、抗血小板药物的有7例。粪性溃疡、AHRUS患者采用电子结肠镜下钛夹夹闭止血、经肛门缝合结扎止血或(电子结肠镜下电凝后)凡士林纱布填塞压迫止血等方式处理后,出血完全控制。异物损伤2例,考虑原因分别为开塞露操作不当、灌肠操作,经肛门缝合结扎止血后出血得以控制。直肠憩室1例,予以蛇毒血凝酶灌肠、凡士林纱布填塞压迫止血后出血得以控制。直肠癌1例,予蛇毒血凝酶灌肠、凡士林纱布填塞压迫止血后症状好转,后由于直肠癌基础疾病,患者家属放弃进一步治疗,患者死亡。结论临床中应对突发无痛性大量便血予以足够重视,早期发现并积极处理对患者的临床转归具有重要的意义。对于老年卧床患者、合并严重基础疾病的卧床患者,要注意考虑粪性溃疡、AHRUS的可能。
