肠白塞病外周血参数在临床诊疗中的价值

目的分析肠白塞病(Behcet’s disease,BD)外周血参数特点及其与肠溃疡活动度的相关性,为全面评估肠BD提供简易方法。方法选择2015年1月—2017年1月复旦大学附属华东医院收治的肠BD患者50例,以单纯皮肤黏膜BD患者50例和复发性阿弗他溃疡(recurrent aphthous ulcer,RAU)患者40例作对照,比较肠BD组外周血参数与单纯皮肤黏膜BD组和RAU组之间的差异。应用简化的内镜下克罗恩病活动度标准(SES-CD)将肠BD分为活动期25例和稳定期25例,评价外周血参数与肠溃疡活动度的相关性。结果与对照组比较,肠BD组红细胞(RBC)、血红蛋白(HGB)明显下降(均P<0.05);纤维蛋白原(FIB)、血沉(ESR)和C-反应蛋白(CRP)明显升高(均P<0.05);HGB和CRP预测肠BD的受试者工作特征曲线(ROC)下面积分别为0.826和0.871;与肠BD稳定期比较肠BD活动期ESR、CRP和FIB显著升高(均P<0.05),HGB显著降低(P=0.001);HGB、ESR、CRP和FIB判断肠溃疡活动度的ROC曲线下面积分别为0.758、0.787、0.888和0.792。结论 BD患者HGB下降和CRP升高时需警惕肠溃疡;HGB、ESR、CRP和FIB是判断肠BD溃疡活动度的简易指标。

Clinical value of peripheral blood parameters in the diagnosis and treatment of intestinal Behcet's disease

Objective To analyze the characteristics of peripheral blood parameters in patients with intestinal Behcet's disease (BD) and its correlation with disease activity, and provide a simple method for the overall evaluation of intestinal BD. Methods A total of 50 patients with intestinal BD in our hospital between January 2015 and January 2017 were enrolled into this study. Total 50 mucocutaneous BD patients (mucocutaneous BD group) and 40 patients with recurrent aphthous ulcer (RAU group) were selected as the control groups. The difference in peripheral blood parameters among the three groups was compared. The simple endoscopic score for Crohn's disease (SES-CD) was used to assign the 50 cases of intestinal BD into active group and stable group with 25 cases each group to evaluate the relationship between hematological parameters and ulcer activity in patients with intestinal BD. Results The RBC and HGB were significantly decreased, however, the level of FIB, ESR and CRP were significantly increased in the intestinal BD when compared with the control groups (all P<0.05). HGB and CRP were able to distinguish intestinal BD with mucocutaneous BD with the areas under the ROC curve of 0.826 and 0.871, respectively. The levels of ESR, CRP and FIB were significantly increased in active intestinal BD (all P<0.05), while the level of HGB was significantly reduced when compare with the stable group (P=0.001). The areas under the ROC curve of HGB, ESR, CRP and FIB for the detection of ulcer activity in intestinal BD were 0.758, 0.787, 0.888 and 0.792, respectively. Conclusion BD patients with low level of hemoglobin and elevated CRP in peripheral blood need to be paid more attentions to BD patients with intestinal ulcer. HGB, ESR, CRP and FIB are simple makers of intestinal ulcer activity in patients with BD.