BACKGROUND Studies have demonstrated a potential role for fecal biomarkers such as fecal calprotectin(FC)and fecal lactoferrin(FL)in monitoring inflammatory bowel diseases(IBD)-Crohn's disease(CD)and ulcerative co...BACKGROUND Studies have demonstrated a potential role for fecal biomarkers such as fecal calprotectin(FC)and fecal lactoferrin(FL)in monitoring inflammatory bowel diseases(IBD)-Crohn's disease(CD)and ulcerative colitis(UC).However,their correlation to endoscopic scores,disease severity and affected intestinal surface has not been extensively investigated.AIM To correlate FL,and for comparison white blood cell(WBC)and C-reactive protein(CRP),with endoscopic scores,disease extent and location in CD and UC.METHODS Retrospective analysis in 188 patients who had FL,CRP and WBC determined within 30 d of endoscopy.Disease location,disease extent(number of intestinal segments involved),disease severity(determined by endoscopic scores),timing of FL testing in relation to colonoscopy,as well as the use of effective fast acting medications(steroids and biologics)between colonoscopy and FL measurement,were recorded.RESULTS In 131 CD and 57 UC patients,both CRP and FL-but not WBC-distinguished disease severity(inactive,mild,moderate,severe).In patients receiving fastacting(steroids or biologics)treatment in between FL and colonoscopy,FL showed a higher correlation to endoscopic scores when tested before vs after the procedure(r=0.596,P<0.001,vs r=0.285,P=0.15 for the Simple Endoscopic Score for CD;and r=0.402,P=0.01 vs r=0.054 P=0.84 for Disease Activity Index).Finally,FL was significantly correlated with the diseased mucosal surface(colon-ileocolon>small bowel)and the number of inflamed colon segments.CONCLUSION FL and CRP separated disease severity categories with FL showing lower discriminating P-values.FL showed a close correlation with the involved mucosal surface and with disease extent and was more closely correlated to endoscopy when determined before the procedure–this indicating that inflammatory activity changes associated with therapy might be rapidly reflected by FL levels.FL can accurately and timely characterize intestinal inflammation in IBD.展开更多
目的探讨尿肠型脂肪酸结合蛋白(IFABP)和粪钙卫蛋白(FC)在新生儿坏死性小肠结肠炎(NEC)中的变化以及与喂养不耐受患儿的鉴别诊断价值.方法以2015年1月~2016年12月收住笔者科室的胎龄(GA)≤34周且出生体重(BW)≤2500g的适于胎龄早产儿90...目的探讨尿肠型脂肪酸结合蛋白(IFABP)和粪钙卫蛋白(FC)在新生儿坏死性小肠结肠炎(NEC)中的变化以及与喂养不耐受患儿的鉴别诊断价值.方法以2015年1月~2016年12月收住笔者科室的胎龄(GA)≤34周且出生体重(BW)≤2500g的适于胎龄早产儿90例为观察对象,共分为3组,即期间发生NEC的患儿作为NEC组,在同期入院的患儿中按照喂养耐受情况,分别作为喂养不耐受组和喂养耐受组(对照组).所有入组患儿均在临床诊断的第1天、第5天分别收集尿液、粪便标本各1份,采用定量酶联免疫吸附方法(ELISA)检测尿液IFABP和FC浓度.结果每组共纳入30例早产儿,NEC组平均胎龄29.8±2.1周,喂养不耐受组平均胎龄30.2±2.4周,对照组平均胎龄30.8±2.5周,3组患儿的胎龄差异无统计学意义(P>0.05).IFABP浓度NEC组在第1天即明显升高,平均为8.821±1.551 ng/ml,第5天时达到11.103±1.718ng/ml,显著高于喂养不耐受组(3.150±1.484ng/ml vs 3.148±1.489ng/ml,P均<0.01)和对照组(3.005±1.430ng/ml vs 3.047±1.216ng/ml,P均<0.01);但第1天和第5天喂养不耐受组与对照组IFABP浓度比较,差异均无统计学意义(P=0.708,0.794).FC浓度NEC组在第1天即明显升高,平均为303.34±59.72μg/g,第5天时达到458.05±121.08μg/g,显著高于喂养不耐受组(176.53±51.31μg/g vs181.29+41.15μg/g,P均<0.01)和对照组(183.54±40.67μg/g vs 181.90+38.80μg/g,P均<0.01);但第1天和第5天喂养不耐受组与对照组FC浓度比较,差异均无统计学意义(P=0.597,0.796).结论尿液IFABP和FC在NEC发生时即有升高,而喂养不耐受患儿无明显升高,尿IFABP联合FC检测可能成为NEC早期诊断和鉴别喂养不耐受患儿的一个敏感而特异的指标.展开更多
基金Supported by an unrestricted research grant from Tech Lab,Blacksburg,VA,United States
文摘BACKGROUND Studies have demonstrated a potential role for fecal biomarkers such as fecal calprotectin(FC)and fecal lactoferrin(FL)in monitoring inflammatory bowel diseases(IBD)-Crohn's disease(CD)and ulcerative colitis(UC).However,their correlation to endoscopic scores,disease severity and affected intestinal surface has not been extensively investigated.AIM To correlate FL,and for comparison white blood cell(WBC)and C-reactive protein(CRP),with endoscopic scores,disease extent and location in CD and UC.METHODS Retrospective analysis in 188 patients who had FL,CRP and WBC determined within 30 d of endoscopy.Disease location,disease extent(number of intestinal segments involved),disease severity(determined by endoscopic scores),timing of FL testing in relation to colonoscopy,as well as the use of effective fast acting medications(steroids and biologics)between colonoscopy and FL measurement,were recorded.RESULTS In 131 CD and 57 UC patients,both CRP and FL-but not WBC-distinguished disease severity(inactive,mild,moderate,severe).In patients receiving fastacting(steroids or biologics)treatment in between FL and colonoscopy,FL showed a higher correlation to endoscopic scores when tested before vs after the procedure(r=0.596,P<0.001,vs r=0.285,P=0.15 for the Simple Endoscopic Score for CD;and r=0.402,P=0.01 vs r=0.054 P=0.84 for Disease Activity Index).Finally,FL was significantly correlated with the diseased mucosal surface(colon-ileocolon>small bowel)and the number of inflamed colon segments.CONCLUSION FL and CRP separated disease severity categories with FL showing lower discriminating P-values.FL showed a close correlation with the involved mucosal surface and with disease extent and was more closely correlated to endoscopy when determined before the procedure–this indicating that inflammatory activity changes associated with therapy might be rapidly reflected by FL levels.FL can accurately and timely characterize intestinal inflammation in IBD.
文摘目的探讨尿肠型脂肪酸结合蛋白(IFABP)和粪钙卫蛋白(FC)在新生儿坏死性小肠结肠炎(NEC)中的变化以及与喂养不耐受患儿的鉴别诊断价值.方法以2015年1月~2016年12月收住笔者科室的胎龄(GA)≤34周且出生体重(BW)≤2500g的适于胎龄早产儿90例为观察对象,共分为3组,即期间发生NEC的患儿作为NEC组,在同期入院的患儿中按照喂养耐受情况,分别作为喂养不耐受组和喂养耐受组(对照组).所有入组患儿均在临床诊断的第1天、第5天分别收集尿液、粪便标本各1份,采用定量酶联免疫吸附方法(ELISA)检测尿液IFABP和FC浓度.结果每组共纳入30例早产儿,NEC组平均胎龄29.8±2.1周,喂养不耐受组平均胎龄30.2±2.4周,对照组平均胎龄30.8±2.5周,3组患儿的胎龄差异无统计学意义(P>0.05).IFABP浓度NEC组在第1天即明显升高,平均为8.821±1.551 ng/ml,第5天时达到11.103±1.718ng/ml,显著高于喂养不耐受组(3.150±1.484ng/ml vs 3.148±1.489ng/ml,P均<0.01)和对照组(3.005±1.430ng/ml vs 3.047±1.216ng/ml,P均<0.01);但第1天和第5天喂养不耐受组与对照组IFABP浓度比较,差异均无统计学意义(P=0.708,0.794).FC浓度NEC组在第1天即明显升高,平均为303.34±59.72μg/g,第5天时达到458.05±121.08μg/g,显著高于喂养不耐受组(176.53±51.31μg/g vs181.29+41.15μg/g,P均<0.01)和对照组(183.54±40.67μg/g vs 181.90+38.80μg/g,P均<0.01);但第1天和第5天喂养不耐受组与对照组FC浓度比较,差异均无统计学意义(P=0.597,0.796).结论尿液IFABP和FC在NEC发生时即有升高,而喂养不耐受患儿无明显升高,尿IFABP联合FC检测可能成为NEC早期诊断和鉴别喂养不耐受患儿的一个敏感而特异的指标.
