【摘要】 目的 探讨血清补体C1q在炎症性肠病(inflammatory bowel disease, IBD)中的诊断与预后作用。方法 采用回顾性随机直接抽样法，选取2021年1月至2022年7月武汉大学人民医院住院患者274例，包括IBD患者180例，其中克罗恩病(Crohn′s disease, CD)患者95例(CD组),溃疡性结肠炎(ulcerative colitis, UC)患者85例(UC组),分别采用CDAI和改良Mayo评分评估CD和UC患者的疾病活动度；结直肠癌患者94例(结直肠癌组)。另选取同期健康体检者79名作为正常对照组。比较各组之间的C1q水平，分析C1q水平与其他指标的相关性以及C1q水平与IBD患者营养状况、器官损伤、电解质水平及凝血功能的关系，用ROC曲线评估C1q预测价值。结果 UC组和CD组患者血清C1q低于正常对照组，结直肠癌组患者血清C1q低于UC组和CD组(P<0.05);IBD组内，疾病活动度重度组患者血清C1q低于缓解期及轻度组；RBC、DBIL、TBIL、白蛋白、肌酐、肾小球滤过率、血钙、血沉、PT、APTT等指标与C1q明显相关；此外，C1q水平可以评价IBD患者营养状况、器官损伤、电解质水平及凝血功能；C1q对IBD患者预后有较高的诊断价值。结论 血清C1q水平对IBD的病情和预后有潜在的临床价值。更多还原

【Abstract】 Objective To investigate the role of serum complement C1q in the diagnosis and prognosis of inflammatory bowel disease(IBD). Methods 274 inpatients in Renmin Hospital of Wuhan University from Jan. 2021 to Jul. 2022 were selected by prospective random sampling, including 180 cases of IBD patients, 95 cases of Crohn′s disease(CD group) and 85 cases of ulcerative colitis(UC group). CDAI and modified Mayo score were used to evaluate the disease activity of CD and UC. 94 patients with colorectal cancer as colorectal cancer group, and 79 healthy subjects in the same period were selected as normal control group. The C1q levels among different groups were compared. The correlation between C1q levels and other indexes and the relationship between C1q levels and nutritional status, organ damage, electrolyte level and blood coagulation function in patients with IBD were discussed. Finally, the predictive value of C1q was evaluated by ROC curve. Results Compared with normal control group, serum C1q in UC group, CD group and colorectal cancer group was significantly lower(P<0.05); in IBD group, serum C1q in severe disease activity group was significantly lower than that in remission group and mild group, and RBC, DBIL, TBIL, albumin, creatinine, glomerular filtration rate, blood calcium, erythrocyte sedimentation rate, PT and APTT were significantly correlated with C1q. In addition, C1q level could evaluate the nutritional status, organ damage, electrolyte level and blood coagulation function of patients with IBD, and C1q had a higher diagnostic value for the prognosis of IBD patients. Conclusion The level of serum C1q has potential clinical value in the condition and prognosis of IBD.更多还原