文章摘要

文章信息/Info

Title:: -

作者:: 宋玉君; 袁泽宇; 郭静; 田字彬; 266121 青岛市第八人民医院消化内科（宋玉君、袁泽宇）, 266003 青岛大学附属医院消化内科（郭静、田字彬）

Author(s):: -

关键词:: 粪便钙卫蛋白; 溃疡性结肠炎; Mayo内镜评分; 病程; 病变范围

Keywords:: -

分类号:: -

DOI:: 10.3969/j.issn.1673-534X.2024.03.011

文献标识码:: -

摘要:: 目的探讨病程、病变范围对粪便钙卫蛋白（FC）评估溃疡性结肠炎（UC）患者内镜下疾病活动度的效能的影响。方法选择2019年6月至2022年12月在青岛市第八人民医院消化内科诊治的148例UC患者作为研究对象，根据病程将其分为0～4年组、5～11年组和12～38年组；根据病变范围将其分为直肠UC组、左半结肠UC组和全结肠UC组。比较各组的FC水平与Mayo内镜评分（MES）的相关性，采用ROC曲线分析各组的FC评估内镜下缓解（MES≤1分）的效能。结果所有患者组及各亚组的FC与MES均呈正相关（P均＜0.001）。在病程分组中，随着病程的延长，FC与MES的相关性逐渐减弱。在病变范围分组中，随着病变范围的扩大，FC与MES的相关性逐渐增强。ROC曲线分析结果显示，0～4年组、全结肠UC组的FC评估UC内镜下缓解的曲线下面积（AUC）均大于其他亚组。结论FC对UC患者内镜下疾病活动度的评估效能受到UC病程长短、病变范围大小的影响，短期病程及广泛病变范围的UC患者的FC评估效能较高。

Abstract:: -

参考文献/References

1 Podolsky DK. Infammatory bowel disease[J]. N Engl J Med, 2002, 347(6): 417-429.
2Colombel JF, Rutgeerts P, Reinisch W, et al. Early mucosal healing with infiximab is associated with improved long-term clinical outcomes in ulcerative colitis[J]. Gastroenterology, 2011, 141(4):1194-1201.
3Barreiro-de Acosta M, Vallejo N, de la Iglesia D, et al. Evaluation of the risk of relapse in ulcerative colitis according to the degree of mucosal healing (Mayo 0 vs 1): A longitudinal cohort study[J]. J Crohns Colitis, 2016, 10(1): 13-19.
4Lichtenstein GR, Rutgeerts P. Importance of mucosal healing in ulcerative colitis[J]. Infamm Bowel Dis, 2010, 16(2): 338-346.
5Rutgeerts P, Vermeire S, Van Assche G. Mucosal healing in infammatory bowel disease: impossible ideal or therapeutic target?[J]. Gut, 2007, 56(4): 453-455.
6Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD:Useful, magic, or unnecessary toys?[J]. Gut, 2006, 55(3): 426-431.
7Ishida N, Miyazu T, Matsuura T, et al. Effect of ulcerative colitis duration on the usefulness of immunochemical fecal occult blood test result as a disease activity biomarker[J]. Int J Colorectal Dis, 2020, 35(9): 1729-1739.
8 吴开春, 梁洁, 冉志华, 等. 炎症性肠病诊断与治疗的共识意见（2018年，北京）[J]. 中国实用内科杂志, 2018, 38(9): 796-813.
9Ungaro R, Mehandru S, Allen PB, et al. Ulcerative colitis[J]. Lancet, 2017, 389(10080): 1756-1770.
10 Turner D, Ricciuto A, Lewis A, et al. STRIDE-Ⅱ: an update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the international organization for the study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD[J]. Gastroenterology, 2021, 160(5): 1570-1583.
11 Silverberg MS, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classifcation of infammatory bowel disease: report of a working party of the 2005 montreal world congress of gastroenterology[J]. Can J Gastroenterol, 2005, 19 Suppl A: 5A-36A.
12 Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classifcation of infammatory bowel disease: controversies, consensus, and implications[J]. Gut, 2006, 55(6): 749-753.
13 Ayling RM, Kok K. Fecal Calprotectin[J]. Adv Clin Chem, 2018, 87:161-190.
14 叶院宁, 汪芳裕. 粪便钙卫蛋白检测在炎症性肠病中的应用价值[J]. 医学研究生学报, 2015, 28(8): 865-869.
15 Lobatón T, Rodríguez-moranta F, Lopez A, et al. A new rapid quantitative test for fecal calprotectin predicts endoscopic activity in ulcerative colitis[J]. Inflamm Bowel Dis, 2013, 19(5): 1034-1042.
16 Schoepfer AM, Beglinger C, Straumann A, et al. Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the lichtiger index, C-reactive protein, platelets, hemoglobin, and blood leukocytes[J]. Inflamm Bowel Dis, 2013, 19 (2): 332-341.
17 Schoepfer AM, Beglinger C, Straumann A, et al. Ulcerative colitis:correlation of the Rachmilewitz endoscopic activity index with fecal calprotectin, clinical activity, C-reactive protein, and blood leukocyte[J]. Inflamm Bowel Dis, 2009, 15(12): 1851-1858.
18 刘文斌, 吕愈敏, 杨雪玲, 等. 粪便钙卫蛋白对溃疡性结肠炎活动性判断价值的研究[J]. 中华消化杂志, 2005, 25 (7): 394-397.
19 ?nal ?K, Beyazit Y, ?ener B, et al. The value of fecal calprotectin as a marker of intestinal inflammation in patients with ulcerative colitis[J]. Turk J Gastroenterol, 2012, 23 (5): 509-514.
20 Osterman MT, Aberra FN, Cross R, et al. Mesalamine dose escalation reduces fecal calprotectin in patients with quiescent ulcerative colitis[J]. Clin Gastroenterol Hepatol, 2014, 12(11): 1887-1893. e3.
21 Lasson A, ?hman L, Stotzer PO, et al. Pharmacological intervention based on fecal calprotectin levels in patients with ulcerative colitis at high risk of a relapse: a prospective, randomized, controlled study[J]. United European Gastroenterol J, 2015, 3(1): 72-79.
22 Hata K, Watanabe T, Kazama S, et al. Earlier surveillance colonoscopy programme improves survival in patients with ulcerative colitis associated colorectal cancer: results of a 23-year surveillance programme in the Japanese population[J]. Br J Cancer, 2003, 89(7):1232-1236.
23 Itzkowitz SH, Harpaz N. Diagnosis and management of dysplasia in patients with infammatory bowel diseases[J]. Gastroenterology, 2004, 126(6): 1634-1648.
24 Beaugerie L, Itzkowitz SH. Cancers complicating infammatory bowel disease[J]. N Engl J Med, 2015, 372(15): 1441-1452.
25 Elkon KB. Review: cell death, nucleic acids, and immunity:infammation beyond the grave[J]. Arthritis Rheumatol, 2018, 70(6):805-816.
26 陈金敏, 高山, 童旭东, 等. 非侵入性分子标志物对溃疡性结肠炎内镜活动度的判断价值[J]. 胃肠病学, 2019, 24(5): 1008-7125.
27 Naganuma M, Kobayashi T, Nasuno M, et al. Signifcance of conducting 2 types of fecal tests in patients with ulcerative colitis[J]. Clin Gastroenterol Hepatol, 2020, 18(5): 1102-1111. e5.
28 Buisson A, Chevaux JB, Hudziak H, et al. Colonoscopic perforations in infammatory bowel disease: a retrospective study in a French referral centre[J]. Dig Liver Dis, 2013, 45(7): 569-572.
29 Navaneethan U, Kochhar G, Phull H, et al. Severe disease on endoscopy and steroid use increase the risk for bowel perforation during colonoscopy in infammatory bowel disease patients[J]. J Crohns Colitis, 2012, 6(4): 470-475.

《国际消化病杂志》[ISSN:1673-534X/CN:31-1953/R]

文章信息/Info

参考文献/References

备注/Memo

常用功能

导航/Navigate

工具/Tools

统计/Statistics