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目的评估非侵入性分子标志物在临床缓解期炎症性肠病(IBD)患者内镜活动度判断中的效能。方法选择2014年8月至2015年2月在南方医院消化内镜中心行电子结肠镜检查的已确诊临床缓解期结肠或回结肠型克罗恩病(CD)34例,溃疡性结肠炎(UC)25例,均于结肠镜检查前1~3 d留取粪便,检测粪便钙卫蛋白(FC)浓度,并搜集血标本检测C反应蛋白(CRP)、红细胞沉降率(ESR)及降钙素原(PCT)浓度。结肠或回结肠型CD及UC患者内镜活动度评估分别采用简单克罗恩病内镜评分(SES-CD)和Mayo评分。结果 34例临床缓解结肠或回结肠型CD中,FC与SESCD相关性最高(r=0.730),FC在临界值250μg/g时,预测内镜活动度的敏感度和特异度分别为93%和70%。25例UC中,FC与Mayo评分相关性最高(r=0.825),FC在临界值250μg/g时,预测内镜活动度的敏感度和特异度分别为84.6%和100.0%。结论 FC能更有效发现临床缓解期IBD内镜下的活动性炎症。
Objective To evaluate the efficacy of noninvasive molecular markers in judging the endoscopic mobility of patients with inflammatory bowel disease (IBD) in clinical remission. Methods From August 2014 to February 2015, 34 cases of Crohn’s disease (CD) with colon or colon-type reaction and 34 cases of clinically re-established colon disease or colon ulcerative colitis undergoing colonoscopy at Nanfang Hospital were enrolled. ) Were collected from 1 to 3 days before colonoscopy. The concentration of fecal calprotectin (FC) was detected and the serum levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and calcitonin Original (PCT) concentration. Endoscopic activity was evaluated in patients with colonic or ileocolonic CD and UC using the simple Crohn’s disease endoscopy score (SES-CD) and Mayo score, respectively. Results The correlation between FC and SESCD was the highest (r = 0.730) in colorectal or colonic CD in 34 cases, and the sensitivity and specificity of FC in predicting the endoscopic activity were at the critical value of 250 μg / g were 93% and 70%. The correlation between FC and Mayo score was the highest in 25 UC patients (r = 0.825). The sensitivity and specificity of FC predicting endoscopic mobility were 84.6% and 100.0% at the critical value of 250 μg / g, respectively. Conclusions FC can be more effective in detecting endoscopic IBD active inflammation in clinical remission.