钙卫蛋白在溃疡性结肠炎患者结肠黏膜及粪便中的表达及临床意义

目的:研究溃疡性结肠炎结肠黏膜及粪便中钙卫蛋白含量与疾病活动性的关系,以及临床使用粪便钙卫蛋白作为炎症活动性标志物的可能性.方法:选取溃疡性结肠炎患者42人和正常对照20人,采用抗钙卫蛋白单克隆抗体对结肠黏膜的钙卫蛋白进行免疫组化分析,同时采用ELISA方法测定粪便中钙卫蛋白含量.溃疡性结肠炎组织学严重程度根据Truelove-Witts标准判断.结果:免疫组化染色显示活动期溃疡性结肠炎的结肠黏膜中有不同强度的钙卫蛋白表达,表达强度与组织学严重程度显著相关(r=0.89,P=0.000 1);缓解期结肠黏膜无或仅有微弱的表达,缓解期与活动期相比差异有统计学意义(P<0.01).ELISA方法测定结果显示,粪便钙卫蛋白含量与结肠黏膜的钙卫蛋白表达强度呈显著相关(r=0.90,P=0.000 7),并且粪便钙卫蛋白含量与组织学严重程度亦显著相关(r=0.849,P<0.01).结论: 溃疡性结肠炎结肠黏膜中的钙卫蛋白可以反映炎症的组织学严重程度,也是粪便中钙卫蛋白的来源,因此检测粪便中的钙卫蛋白可以反映炎症的组织学严重程度.该检测方法简便可行.

Expression of calprotectin in colon mucosa and fecal of patients with ulcerative colitis

Objective:To investigate the correlation between the disease activity of ulcerative colitis (UC) and the immunohistochemical distribution of calprotectin in colon mucosa,as well as the levels of calprotectin in fecal. Methods:Monoclonal antibody against calprotectin was used to investigate the distribution of these proteins in colon mucosa from 42 patients with ulcerative colitis and 20 healthy controls. ELISA assay was used to measure the concentrations of calprotectin in fecal. The disease activity of UC was determined by Truelove-Witts histological criteria. Results: Calprotectin was demonstrated in the majority of granulocytes and macrophages in colon mucosa of patients with active UC, while negative in patients with unactive UC and healthy controls. A strong calprotectin immunoreactivity was presented in ulcerative and erosion lesions in the colon. The concentration of calprotectin was significantly higher in patients with active UC than that with unactive UC and healthy controls (P<0.01). Both the distribution of calprotectin in colon mucosa and the levels of calprotectin in fecal in UC were significantly correlated with the histological grades respectively(r=0.89,P=0.000 1;r=0.849,P<0.01), and the two parameters were correlated well(r=0.90, P=0.000 7).Conclusion: We suggest that calprotecin in fecal is mostly derived from the colon mucosa in active UC. The level of in fecal calprotectin fecal accurately reflects the degree of disease activity of UC. The morphological results confirm the findings of enhanced fecal calprotectin levels in patients with active UC.