【摘要】 目的评价粪便钙卫蛋白测定作为一种非侵入性方法判断溃疡性结肠炎(UC)活动性的价值,并与目前临床最常用的客观指标红细胞沉降率(ESR)和C反应蛋白(CRP)进行比较。方法确诊的UC患者76例,在结肠镜检查前1周内留取5g粪便进行粪便钙卫蛋白测定,采用ELISA方法检测;同时检查血红蛋白、白蛋白、ESR和CRP,记录患者1周内的临床表现。疾病活动性根据内镜和组织学标准判断。取结肠镜正常的61例门诊患者粪便样本作为对照。结果活动期UC组粪便钙卫蛋白水平(515μg/g)显著高于缓解期(7.5μg/g,P<0.01)和正常对照(5.7μg/g,n=61,P<0.01),后两者之间差异无统计学意义(P>0.05);缓解期与活动期各级(Ⅰ、Ⅱ、Ⅲ期)差异有统计学意义(P<0.01);粪便钙卫蛋白水平与活动期UC内镜分级显著相关(r=0.876,P<0.01),CRP和ESR与内镜分级的相关系数分别为r=0.725(P<0.01)和r=0.302(P<0.01),低于粪便钙卫蛋白。结论粪便钙卫蛋白与UC内镜分级标准具有较好的相关性,可客观反映UC的炎症活动情况,比血清学指标ESR和CRP更敏感和特异;而且是一种方便无创的检查方法,可以弥补内镜检查痛苦大、价格高、不宜反复检查的不足。具有临床推广价值。更多还原

【Abstract】 Objective To evaluate the accuracy of fecal calprotectin as a non-invasive indicator of disease activity in ulcerative colitis (UC) in comparison with colonoscopy, erythrocyte sedimentation rate(ESR) and serum C-reactive protein (CRP). Methods Sixty-one outpatients as controls and 76 patients with UC were recruited after colonoscopy. All the patients were asked to collect 5 g of stool sample one week before colonoscopy for determining fecal calprotectin by an enzyme-linked immunosorbent assay. The disease activity of UC was evaluated according to colonoscopic and histological criteria. CRP, erythrocyte sedimentation rate, hemoglobin, white blood cell and liver function were also measured. Results The fecal calprotectin concentration among patients with active UC (median 515 μg/g, n=69) was significantly higher than that of inactive UC group (7.5 μg/g, P<0.01) and healthy controls (5.7 μg/g,n=61, P<0.01), while the difference between the control group and the inactive group was not statistically significant (P>0.05). Significant difference existed between each active grades (Ⅰ, Ⅱ, Ⅲ) and inactive phase of UC. The results revealed a significant correlation between the endoscopic grades of disease activity and faecal calprotectin concentration (r=0.876,P<0.01). The correlation coefficient between CRP/ESR and histological grades were 0.725 (P<0.01) and 0.302( P<0.01 ) respectively. Both were lower than that of calprotectin. Conclusions Faecal calprotectin levels reflect the disease activity in UC and can be used to monitor the response to treatment and detect relapses. It was an objective, simple and noninvasive measurement and was better than ESR and serum CRP.更多还原