粪便钙卫蛋白及髓过氧化物酶在评估溃疡性结肠炎活动性的应用
분편개위단백급수과양화물매재평고궤양성결장염활동성적응용
Application of fecal calprotectin and myeloperoxidase in evaluation of disease activity of ulcerative colitis
  • 万方数据
    中华检验医学杂志 중화검험의학잡지
    CHINESE JOURNAL OF LABORATORY MEDICINE
    2013年 4期 348-351 ,共4页

    柏明见%龙彦%冯珍如%李俊霞%闫存玲%李志艳%史晓敏%郑新芝

    백명견%룡언%풍진여%리준하%염존령%리지염%사효민%정신지

    结肠炎,溃疡性%白细胞L1抗原复合物%过氧化物酶%粪便%生物学标记%敏感性与特异性 結腸炎,潰瘍性%白細胞L1抗原複閤物%過氧化物酶%糞便%生物學標記%敏感性與特異性
    결장염,궤양성%백세포L1항원복합물%과양화물매%분편%생물학표기%민감성여특이성
    Colitis,ulcerative%Leukocyte L1 antigen complex%Peroxidase%Feces%Biological markers%Sensitivity and specificity
    目的 探讨粪钙卫蛋白、髓过氧化物酶评估溃疡性结肠炎疾病活动性的应用价值.方法 本研究属于横断面研究.选取2010年1月到2012年4月就诊于北京大学第一医院消化内科的溃疡性结肠炎(UC)患者49例,男32例,女17例,中位年龄40岁(13～ 80岁),留取患者血及粪便标本,同时搜集患者临床资料,采用Mayo评分系统将UC患者分为缓解期组(22例)和活动期组(27例),其中活动期组分为轻、中、重度3组(分别为6、9、12例).选取无消化道症状、便常规及便潜血检查均阴性,经内镜检查排除UC诊断,排除有严重心、肺、肾脏疾患的健康体检者作为对照组,男23例,女12例,中位年龄43岁(24 ～ 75岁),留取其血清及粪便.采用ELISA检测两组粪提取液中钙卫蛋白、髓过氧化物酶含量.将各组中粪钙卫蛋白、髓过氧化物酶、ESR及血清C反应蛋白(CRP)分别进行比较,同时将其与Baron内镜分级、Mayo临床活动指数进行相关性分析,并绘制ROC曲线.结果 UC活动期组粪钙卫蛋白含量显著高于缓解期组[6000.0(3050.8,8759.5)vs 336.8 (227.5,1731.0),Z=-3.357,P=0.001],缓解期组显著高于对照组[336.8(227.5,1731.0) vs 29.0(21.3,48.8),Z=-5.607,P=0.001]；UC活动期组粪便髓过氧化物酶含量显著高于缓解期组[1231.2(757.9,1481.1) vs 603.6(265.2,819.4),Z=-3.658,P=0.001],缓解期组高于对照组[603.6(265.2,819.4)vs 453.5(140.8,750.2),Z=-1.033,P=0.302]；粪钙卫蛋白在轻度与中度活动组相比差异有统计学意义[5302.3(1140.5,9531.0) vs 5696.8(5510.0,7593.0),Z=-0.236,P=0.918],在中度与重度活动组相比差异有统计学意义[5696.8 (5510.0,7593.0) vs.6000(4284.0,9793.0),Z=-0.924,P=0.382];粪髓过氧化物酶在轻度与中度活动组相比差异有统计学意义[667.3(467.5,1000.4) vs 1259.6(1213.3,1932.8),Z=-2.475,P=0.005,在中度与重度活动组相比差异有统计学意义[1259.6(1213.3,1932.8)vs 1239.0(793.9,1403.0),Z=-1.350,P=0.193].粪钙卫蛋白、粪髓过氧化物酶、ESR、血清CRP的测定值与Baron内镜分级相关系数分别为:R=0.382、0.499、0.359、0.246,相应P值分别为:P =0.007、0.001、0.010、0.093;与Mayo评分相关系数分别为:R=0.476、0.515、0.347、0.365,相应P值分别为:P =0.001、0.001、0.020、0.011.结论 粪钙卫蛋白、髓过氧化物酶作为无创的生物标记物,在监测UC患者疾病活动性方面与指南中作为Mayo活动性评分组成的ESR、血CRP一样,与UC活动性均呈较好的相关性,粪钙卫蛋白在区分缓解期UC与对照组方面优于粪髓过氧化物酶.(中华检验医学杂志,2013,36:348-351)
    목적 탐토분개위단백、수과양화물매평고궤양성결장염질병활동성적응용개치.방법 본연구속우횡단면연구.선취2010년1월도2012년4월취진우북경대학제일의원소화내과적궤양성결장염(UC)환자49례,남32례,녀17례,중위년령40세(13～ 80세),류취환자혈급분편표본,동시수집환자림상자료,채용Mayo평분계통장UC환자분위완해기조(22례)화활동기조(27례),기중활동기조분위경、중、중도3조(분별위6、9、12례).선취무소화도증상、편상규급편잠혈검사균음성,경내경검사배제UC진단,배제유엄중심、폐、신장질환적건강체검자작위대조조,남23례,녀12례,중위년령43세(24 ～ 75세),류취기혈청급분편.채용ELISA검측량조분제취액중개위단백、수과양화물매함량.장각조중분개위단백、수과양화물매、ESR급혈청C반응단백(CRP)분별진행비교,동시장기여Baron내경분급、Mayo림상활동지수진행상관성분석,병회제ROC곡선.결과 UC활동기조분개위단백함량현저고우완해기조[6000.0(3050.8,8759.5)vs 336.8 (227.5,1731.0),Z=-3.357,P=0.001],완해기조현저고우대조조[336.8(227.5,1731.0) vs 29.0(21.3,48.8),Z=-5.607,P=0.001]；UC활동기조분편수과양화물매함량현저고우완해기조[1231.2(757.9,1481.1) vs 603.6(265.2,819.4),Z=-3.658,P=0.001],완해기조고우대조조[603.6(265.2,819.4)vs 453.5(140.8,750.2),Z=-1.033,P=0.302]；분개위단백재경도여중도활동조상비차이유통계학의의[5302.3(1140.5,9531.0) vs 5696.8(5510.0,7593.0),Z=-0.236,P=0.918],재중도여중도활동조상비차이유통계학의의[5696.8 (5510.0,7593.0) vs.6000(4284.0,9793.0),Z=-0.924,P=0.382];분수과양화물매재경도여중도활동조상비차이유통계학의의[667.3(467.5,1000.4) vs 1259.6(1213.3,1932.8),Z=-2.475,P=0.005,재중도여중도활동조상비차이유통계학의의[1259.6(1213.3,1932.8)vs 1239.0(793.9,1403.0),Z=-1.350,P=0.193].분개위단백、분수과양화물매、ESR、혈청CRP적측정치여Baron내경분급상관계수분별위:R=0.382、0.499、0.359、0.246,상응P치분별위:P =0.007、0.001、0.010、0.093;여Mayo평분상관계수분별위:R=0.476、0.515、0.347、0.365,상응P치분별위:P =0.001、0.001、0.020、0.011.결론 분개위단백、수과양화물매작위무창적생물표기물,재감측UC환자질병활동성방면여지남중작위Mayo활동성평분조성적ESR、혈CRP일양,여UC활동성균정교호적상관성,분개위단백재구분완해기UC여대조조방면우우분수과양화물매.(중화검험의학잡지,2013,36:348-351)
    Objective To explore the clinical value of fecal calprotectin and myeloperoxidase in evaluation of ulcerative colitis (UC) activity.Methods Specimens of serum and feces over the same period were collected from 49 ulcerative colitis (UC) patients (32 male and 17 female)and 35 healthy controls (23 male and 12 female).ELISA was used to measure the concentration of calprotectin and myeloperoxidase in feces.The clinical information (including Mayo clinic activity index.Baron endoscopic score) of UC patients were collected.All patients were divided into active and inactive group by Mayo clinic activity index,the active group was further divided into three subgroups,the mild group,the moderate group and the severe group.Fecal calprotectin and myeloperoxidase,serum ESR and CRP were compared among different groups,receiver operating curve (ROC) were obtained to evaluate the diagnostic efficacy of the UC activity.Results The fecal calprotectin concentration was significantly higher in active UC group than that in inactive UC group [6000.0 (3050.8,8759.5) vs.336.8 (227.5,1731.0),Z =-3.357,P =0.001],the same to inactive UC group and the controls[336.8(227.5,1731.0) vs.29.0(21.3,48.8),Z =-5.607,P =0.001].The fecal myeloperoxidase concentration of the active UC group was significantly higher than that of the inactive UC group[1231.2(757.9,1481.1) vs.603.6(265.2,819.4),Z =-3.658,P =0.001],but there was no significant difference between the inactive UC group and the controls [603.6 (265.2,819.4) vs.453.5(140.8,750.2),Z =-1.033,P =0.302].There was no significant difference of fecal calprotectin levels among different active subgroups.Fecal myeloperoxidase concentration between the mild activity group and the moderate activity group was significant [667.3 (467.5,1000.4) vs.1259.6 (1213.3,1932.8),Z =-2.475,P =0.005],but there was no significant difference between the moderate activity group and the severe activity group [1259.6 (1213.3,1932.8) vs.1239.0 (793.9,1403.0),Z =-1.350,P =0.193].The four biomarkers were all positively correlated with the endoscopic score and Mayo clinic activity index of UC.Conclusions Considered as noninvasive biomarkers of disease activity fecal calprotectin and myeloperoxidase is similar to ESR and serum CRP.Fecal calprotectin is superior to myeloperoxidase in differentiating the inactive UC group from the controls.(Chin J Lab Med,2013,36:348-351)
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