粪便钙卫蛋白在克罗恩病活动度判断中的诊断效能

目的：研究粪便钙卫蛋白（FC）在结肠或回结肠型克罗恩病（CD）及 CD 术后患者内镜下活动度判断中的诊断效能。方法选取已确诊结肠或回结肠型 CD 患者56例、CD 术后患者25例及肠易激综合征（IBS）患者25例。均于结肠镜检查前1～3 d内留取粪便，采用 ELISA 方法测定 FC 的水平。结肠或回结肠型 CD 及 CD 术后患者内镜活动度评估分别采用简单克罗恩病内镜评分（SES-CD）和 Rutgeerts′评分。结果在结肠或回结肠型 CD 患者中，活动期 FC 水平明显高于缓解期和 IBS 组（P＜0．01），FC 水平与 SES-CD 评分呈正相关（r＝0．802，P＜0．01），FC 在临界值250μg／g 时预测内镜活动度的灵敏度和特异度分别为97．1％和71．4％。在 CD 术后患者中，活动期及缓解期 FC 水平均明显高于 IBS 组（P ＜0．01），但活动期 FC 水平与缓解期相比差异无统计学意义（P＞0．05），FC 在临界值250μg／g 时预测内镜疾病复发的灵敏度和特异度分别为50．0％和66．7％。结论 FC 能准确地反映结肠或回结肠型 CD 患者内镜疾病的活动度，但 FC 不能区别 CD 术后患者疾病的缓解期和活动期。

Diagnostic efficacy of fecal calprotectin on assessing crohn′s disease activity

Objective To investigate the diagnostic efficacy of fecal calprotectin(FC) on assessing endoscopic disease activity in colonic or ileo-colonic Crohn disease (CD) and CD-related surgery patients .Methods Totally 56 colonic or ileo-colonic CD pa-tients ,25 CD-related surgery patients and 25 irritable bowel syndrome (IBS) patients with previously confirmed diagnosis of CD and IBS were enrolled into this study .Fecal samples were collected from 1 to 3 day before bowel preparation and FC was measured by ELISA .Endoscopic activity was determined for colonic or ileo-colonic CD with Simple Endoscopic Score for Crohn′s Disease (SES-CD) and CD-related surgery patients with the Rutgeerts′ score .Results Among colonic or ileo-colonic CD patients ,the levels of FC in endoscopic active patients had significantly higher than that of endoscopic remission patients and IBS patients(P < 0 .01) ,there was significant correlation between levels of FC and the SES-CD (r= 0 .802 ,P< 0 .01) .FC threshold of 250 μg/g was tested to in-dicated active endoscopic disease with 97 .1% sensitivity and 71 .4% specificity .Among CD-related surgery patients ,FC level in IBS patients were significantly lower than that of endoscopic remission patients and endoscopic active patients ,but the FC in endoscopic remission patients and endoscopic active patients had no statistic difference(P> 0 .05) ,FC cutoff level of 250 μg /g gave a sensitivity and specificity of 50 .0% ,66 .7% ,respectively .Conclusion FC is a surrogate marker for the evaluation of colonic or ileo-colonic CD endoscopic disease activity .The FC ,however ,can not distinct remission period and active period after CD surgery .