粪便钙卫蛋白对克罗恩病病情评估价值的研究

发布时间：2018-06-06 14:37

本文选题：克罗恩病 + 粪便钙卫蛋白　；参考：《苏州大学》2016年硕士论文

【摘要】：【目的】目前国内关于克罗恩病(Crohn’S disease,CD)患者的粪便钙卫蛋白(fecal calprotectin,FC)与简化克罗恩病内镜评分标准(SESCD)、血清学指标、CDAI之间的相关性研究以及其对克罗恩病病情评估能力等方面的研究较少。本研究的主要目的:一是评估粪便钙卫蛋白和SESCD、血清学指标和CDAI之间的相关性。二是研究粪便钙卫蛋白对克罗恩病病情评估的能力。【方法】以我院消化科在2013年11月份至2016年1月份收治的资料完整的克罗恩病患者为研究对象。记录每例研究对象的基本情况、病史、血清学检查、粪便钙卫蛋白浓度、内镜检查、影像学检查信息,共20例。将数据录入SPSS17.0 for Windows软件进行统计学处理。【结果】1.FC、CDAI、CRP、WBC、ESR、PLT、HB、ALB区分克罗恩病缓解期与活动期的能力:根据SESCD评分将患者分为2组:疾病活动组(SESCD3),15例(75%),疾病非活动组(SESCD≤3)5例(25%)。疾病活动组FC、CDAI、CRP、WBC、ESR、PLT中位数(四分位间距)分别为1800(IQR1000-1800)ug/g、213(100-350)、25(11-73.4)mg/L、6.4(5.1-7.5)×109/L、25(12-41)mm/H、315(235-370)×109/L,明显高于疾病非活动组的105(62-221)ug/g、71.1(60.5-104.1)、6.8(3.65-7.2)mg/L、4.6(3.3-6)×109/L、6(5-8.5)mm/H、273(167-312.5)×109/L,除PLT外差异均有统计学意义(P0.05)。疾病活动组HB、ALB水平低于疾病非活动组,但无统计意义上的差异(P0.05)。2.FC、CDAI、CRP、WBC、ESR、PLT、HB、ALB区分疾病非活动期、轻度活动期、中重度活动期的能力:将分组细化为疾病非活动组(SESCD≤3)5例(25%),轻度活动组(4-10分)4例(20%),中重度活动组(≥11分)11例(55%)。进行3组之间的两两比较发现,只有FC在非活动期与轻度活动期(P0.017)、轻度活动期与中重度活动期之间有差别(P0.017)。3.spearman’s等级相关分析:SESCD与FC、CDAI、CRP、WBC、ESR、ALB的spearman’s等级相关系数分别为0.934、0.42、0.49、0.529、0.725、-0.454,均有统计学意义上的相关性(P0.05)。与SESCD的相关强度依次是FC、ESR、WBC、CRP、ALB、CDAI。而SESCD和PLT、HB无统计学意义上的相关性(P0.05)。FC与CDAI、CRP、WBC、ESR、ALB的spearman’s等级相关系数分别为0.466、0.583、0.574、0.678、-0.394,均有统计学意义上的相关性(P0.05),相关强度依次是ESR、CRP、WBC、CDAI、ALB。而FC和PLT、HB无统计学意义上的相关性(P0.05)。4.FC、ESR、CRP、CDAI、WBC、ALB预测内镜下疾病活动的准确性:ROC曲线分析显示FC、ESR、CRP、CDAI、WBC、ALB曲线下面积依次是1、0.94、0.913、0.867、0.833、0.84,与0.5相比具有统计学差异(P0.05)。ROC曲线分析得出的FC、ESR、CRP、CDAI、WBC、ALB预测内镜下疾病活动的最佳截点值依次是221ug/g、11mm/H、9.15mg/L、141、5.05×109/L、40.95g/L。【结论】1.FC、CDAI、CRP、WBC、ESR均能预测内镜下克罗恩病的活动性炎症,预测内镜下疾病活动性炎症的准确性大小依次是FC、ESR、CRP、CDAI、WBC。FC、ESR、CRP、CDAI、WBC预测内镜下疾病的活动性炎症的最佳截点值依次是221ug/g、11mm/H、9.15mg/L、141、5.05×109/L。2.在FC、CDAI、CRP、WBC、ESR中,只有FC在疾病非活动期与轻度活动期、轻度活动期与中重度活动性期之间有差别。3.与SESCD评分相关性最强的是FC,然后依次是ESR、WBC、CRP、ALB、CDAI。
[Abstract]:[Objective] at present, there are few studies on the fecal caldin (fecal calprotectin, FC) in Crohn 'S disease (CD) patients with the simplified endoscopic score standard for Crohn's disease (SESCD), the correlation between the serological index, CDAI and the ability to assess the disease condition of Crohn's disease. The first is to assess the correlation between fecal caldin and SESCD, serological indicators and CDAI. Two is the ability to evaluate the assessment of Crohn's disease by faecal caldin. [Methods] a complete group of Crohn patients from November 2013 to January 2016 in our hospital were studied. Basic conditions, medical history, serological examination, fecal caldin concentration, endoscopy, and imaging information, 20 cases. The data were recorded in SPSS17.0 for Windows software for statistical processing. [results] 1.FC, CDAI, CRP, WBC, ESR, PLT, HB, ALB differentiated the ability of Crohn's remission and activity: the patients were divided into 2 groups according to the SESCD score: The disease active group (SESCD3), 15 (75%), and 5 cases (25%) of the disease non active group (SESCD < 3). The median of the disease active group FC, CDAI, CRP, WBC, ESR, and PLT (four) are 1800 (IQR1000-1800) ug/g, 213 (100-350), 25 (11-73.4) mg/L, 6.4 (12-41), 25 (12-41) * * *, obviously higher than those of the disease non activity group /g, 71.1 (60.5-104.1), 6.8 (3.65-7.2) mg/L, 4.6 (3.3-6) x 109/L, 6 (5-8.5) mm/H, 273 (167-312.5) x 109/L, except PLT heterodyne (P0.05). The ability of moderate and severe active period: 5 cases (SESCD < 3) was divided into 5 cases (25%), 4 cases (20%) of mild activity group (20%), and 11 cases (55%) in moderate and severe activity group (55%). The results of 3 groups were found, only FC was in the inactive and mild period (P0.017), and there was a difference between mild and moderate and severe active period (P (0.017).3.spearman 's level correlation analysis: SESCD and FC, CDAI, CRP, WBC, ESR, ALB Spearman' s rank correlation coefficient respectively. P0.05, CDAI, CRP, WBC, ESR, ALB Spearman 's grade correlation coefficients are 0.466,0.583,0.574,0.678, -0.394, and there are statistical correlations (P0.05). ROC curve analysis shows that FC, ESR, CRP, CDAI, WBC, the area under the ALB curve is 1,0.94,0.913,0.867,0.833,0.84, compared with 0.5, there is a statistical difference (P0.05).ROC curve analysis. /L. [Conclusion] 1.FC, CDAI, CRP, WBC, ESR can predict the active inflammation of the endoscopic Crohn's disease. The accuracy of predicting the accuracy of active inflammation in endoscopy is FC, ESR, CRP, CDAI, WBC.FC. In FC, CDAI, CRP, WBC, and ESR, only FC was in the period of disease inactivity and mild activity, and there was a difference between.3. and SESCD score between the mild and moderate and severe active stages, and FC was the strongest, followed by ESR, WBC, CRP, and SESCD.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R574.62

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