肠道炎症负担程度评分对溃疡性结肠炎炎症负担评价的研究

目的:探讨溃疡性结肠炎(UC)肠道炎症负担程度(DUBLIN)评分在评价UC炎症负担中的临床价值。方法:选取在医院就诊的120例UC患者肠镜检查的内窥镜评分资料,另随机选取120名同期在医院体检的健康体检者外周血标本资料。对比分析UC患者外周血炎症指标白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(N)、单核细胞计数(M)、血红蛋白浓度(Hb)、白蛋白(Alb)、淋巴细胞计数(L)和C-反应蛋白(CRP)与健康体检者的差异,分析UC患者的DUBLIN评分与炎症指标及内窥镜梅奥评分(EMS)、UC内窥镜下严重程度指数(UCEIS)的相关性,并评价DUBLIN、EMS和UCEIS的3种内窥镜评分对CRP>5 mg/L、重度UC(Truelove-Witts分度标准)的判断效能。结果:UC患者与健康体检者比较,其WBC、PLT及N升高,而L、Hb和Alb降低,采用Mann-Whitney U非参数检验,差异有统计学意义,单核细胞计数(M)的差异无统计学意义。UC患者的DUBLIN评分与WBC、PLT、N、M、血沉(ESR)和CRP呈正相关(r=0.223,r=0.216,r=0.224,r=0.287,r=0.402,r=0.432;P<0.05),而与Hb、Alb呈负相关(r=-0.279,r=-0.373;P<0.05)。DUBLIN评分与EMS、UCEIS评分相关性较好(r=0.543,r=0.514;P<0.05)。对CRP>5 mg/L和重度UC的判断效能DUBLIN曲线下面积(AUC)高于EMS和UCEIS。结论:DUBLIN评分与UC的外周血炎症指标以及内窥镜EMS、UCEIS评分具有相关性,可用于评价UC的炎症负担,且具有较高的临床应用价值。

Clinical significance of DUBLIN scores in the evaluation of UC inflammatory burden

Objective:To investigate the clinical significance of Degree of Ulcerative colitis Burden of Luminal Inflammation(DUBLIN)score of ulcerative colitis(UC)in the evaluation of UC inflammatory burden.Methods:The scores data of endoscope of 120 patients with UC who received treatment in hospital were selected,and the data of peripheral blood of 120 health individuals who underwent physical examination at the same time were selected as random method.The differences of peripheral blood inflammation indicators included white blood cell count(WBC),platelet count(PLT),neutrophil count(N),monocyte count(M),hemoglobin(Hb),albumin(Alb),lymphocyte(L)and C-reactive protein(CRP)between 120 patients with UC and 120 healthy individuals were compared and analyzed.The correlations between DUBLIN score and inflammation index,endoscopic Mayo score(EMS)and ulcerative colitis endoscopic index of severity(UCEIS)of patients with UC were analyzed.And the judging efficacies of three endoscopic scores included DUBLIN,EMS and UCEIS when CRP>5 mg/L and severe UC(Truelove-Witts criterion)were evaluated.Results:Compared with healthy individuals,WBC,PLT and N of patients with UC were higher,while L,Hb and Alb of them were lower.And the differences of these indicators between two group were significant as Mann-Whitney U non-parametric test(P<0.05).And the difference of M between the two groups was no significant.And the DUBLIN score of patients with UC was significantly positive correlation with WBC,PLT,N,M,ESR and CRP of them,and was significantly negative correlation with Hb and Alb of them(r=0.223,r=0.216,r=0.224,r=0.287,r=0.402.r=0.432,r=-0.279,r=-0.373,P<0.05).The correlations between DUBLIN score and EMS,and UCEIS(r=0.543,r=0.51,P<0.001)were better.When CRP>5 mg/L and severe UC,the area under curve(AUC)of judgment efficacies of DUBLIN was higher than that of EMS and UCEIS.Conclusion:The DUBLIN score has correlation with peripheral blood inflammation indexes of UC,and endoscopic EMS and UCEIS.And it can be used to evaluate the inflammatory burden of UC and it has higher clinical application value.