CAJ | 학술논문

目的研究粪钙卫蛋白、乳铁蛋白水平与克罗恩病肠黏膜病变的关系.方法选取88例经确诊的克罗恩病(CD)患者为研究对象,35例肠易激综合征(IBS)患者为对照.CD患者于肠镜检查前1周内、IBS患者于门诊就诊时分别留取粪便标本.其中CD患者同时计算CD活动指数(CDAI),并在其后的内镜检查中计算CD内镜指数(CDEI).通过酶联免疫吸附法检测粪钙卫蛋白和乳铁蛋白水平.结果 CD患者粪钙卫蛋白、乳铁蛋白水平[中位值(四分位数间距)]分别为277.16 (96.85~693.57) mg/kg和59.68(10.75～100.58) mg/kg,明显高于IBS患者[7.6(5.54～32.3) mg/kg和0.65(0.23～4.34) mg/kg],差异均有统计学意义(Z值分别=-8.301和-7.986,P值均=0.000).存在结肠病变的CD患者粪钙卫蛋白、乳铁蛋白水平与无结肠病变的CD患者比较差异均无统计学意义(Z值分别=-0.424和-0.699,P值分别=0.672和0.485).CD缓解期者粪钙卫蛋白、乳铁蛋白水平与CD活动期者比较,差异均无统计学意义(Z值分别=-1.491和-1.075,P值分别=0.136和0.283).内镜中重度活动期者粪钙卫蛋白、乳铁蛋白水平分别为663.11(263.45～2015.63) mg/kg、105.64(56.52～187.44) mg/kg,轻度活动期者分别为344.54(132.03～722.67) mg/kg、86.68(21.07～100.55) mg/kg,静止期者分别为133.94(60.54～583.33) mg/kg、45.31(7.59～48.31) mg/kg,各活动期患者粪钙卫蛋白和乳铁蛋白水平高于静止期(χ2分别=10.63和8.18,P值分别=0.005和0.017).结论粪钙卫蛋白、乳铁蛋白水平可反映肠道黏膜病变及其严重程度.
목적 연구분개위단백、유철단백수평여극라은병장점막병변적관계.방법 선취88례경학진적극라은병(CD)환자위연구대상,35례장역격종합정(IBS)환자위대조.CD환자우장경검사전1주내、IBS환자우문진취진시분별류취분편표본.기중CD환자동시계산CD활동지수(CDAI),병재기후적내경검사중계산CD내경지수(CDEI).통과매련면역흡부법검측분개위단백화유철단백수평.결과 CD환자분개위단백、유철단백수평[중위치(사분위수간거)]분별위277.16 (96.85~693.57) mg/kg화59.68(10.75～100.58) mg/kg,명현고우IBS환자[7.6(5.54～32.3) mg/kg화0.65(0.23～4.34) mg/kg],차이균유통계학의의(Z치분별=-8.301화-7.986,P치균=0.000).존재결장병변적CD환자분개위단백、유철단백수평여무결장병변적CD환자비교차이균무통계학의의(Z치분별=-0.424화-0.699,P치분별=0.672화0.485).CD완해기자분개위단백、유철단백수평여CD활동기자비교,차이균무통계학의의(Z치분별=-1.491화-1.075,P치분별=0.136화0.283).내경중중도활동기자분개위단백、유철단백수평분별위663.11(263.45～2015.63) mg/kg、105.64(56.52～187.44) mg/kg,경도활동기자분별위344.54(132.03～722.67) mg/kg、86.68(21.07～100.55) mg/kg,정지기자분별위133.94(60.54～583.33) mg/kg、45.31(7.59～48.31) mg/kg,각활동기환자분개위단백화유철단백수평고우정지기(χ2분별=10.63화8.18,P치분별=0.005화0.017).결론 분개위단백、유철단백수평가반영장도점막병변급기엄중정도.
Objective To study the correlation of fecal calprotectin and lactoferrin with intestinal mucosa lesions in Crohn′s disease (CD). Methods Eighty-eight cases of diagnosed CD patients were selected as study group and 35 irritable bowel syndrome (IBS) patients were as controls. Fecal samples of CD patients were collected in one week before colonoscopy examination and of IBS patients were collected of CD patients, CD activity index (CDAI) was calculated at same visit, and CD endoscopic index (CDEI) was calculated in the subsequent endoscopic examination. The level of fecal calprotectin and lactoferrin were tested by ELISA method. Results The median levels of facal calprotectin and lactoferrin in CD patients were 277.16 mg/kg (from 96.85 to 693.57 mg/kg) and 59.68 mg/kg (from 10.75 to 100.58 mg/kg) respectively, which were significantly higher than those of IBS patients (7.6mg/kg, from 5.54 to 32.3 mg/kg and 0.65 mg/kg from 0.23 to 4.34 mg/kg), (Z=-8.301 and -7.986, respectively both P =0.000). There were no significant difference of calprotectin and lactoferrin level between CD patients with colon pathological changes and without colon pathological changes (Z=-0.424 and -0.699,P=0.672 and 0.485, respectively). There was no significant difference of calprotectin and lacoferrin level between remission and active periods in CD patients (Z=-1.491 and -1.075, P=0.136 and 0.283, respectively). The median values of calprotectin and lactoferrin of patients in moderate and severe active period judged under endoscopy were 663.11 mg/kg (from 263.45 to 2015.63 mg/kg) and 105.64 mg/kg (from 56.52 to 187.44) mg/kg respectively, in mild active period were 344.54 mg/kg (from 132.03 to 722.67 mg/kg) and 86.68 mg/kg (from 21.07 to 100.55 mg/kg) accordingly, and in remission period were 133.94 mg/kg (from 60.54 to 583.33 mg/kg) and 45.31 mg/kg (from 7.59 to 48.31 mg/kg, respectively). Both calprotectin and lactoferrin levels were significantly higher in active period than in remission period (χ2=10.63 and 8.18, while, P=0.005 and 0.017, respectively). Conclusions The level of fecal calprotectin and lactoferrin can reflect the pathological changes and severity of the intestinal mucosa.