摘要
评估血清抗组织转谷氨酰胺酶抗体(抗tTG抗体)滴度与十二指肠黏膜损伤严重程度的相关性,预测国内人群抗tTG抗体滴度诊断乳糜泻及绒毛萎缩的最佳临界值。回顾性分析2017年7月至2022年1月就诊于新疆维吾尔自治区人民医院的76例抗tTG抗体阳性同时行十二指肠活检的成年乳糜泻患者临床及病理资料,统计分析血清抗tTG抗体滴度与十二指肠黏膜损伤严重程度的相关性,预测抗tTG抗体滴度诊断乳糜泻及绒毛萎缩的最佳临界值。在76例患者中,10例被认为是潜在乳糜泻,66例有十二指肠组织病理学改变的患者中,4例为MarshⅠ级,6例为MarshⅡ级,56例为MarshⅢa-c级。统计分析显示,成人乳糜泻的抗tTG抗体滴度与十二指肠黏膜组织病理学损伤的严重程度有关。抗tTG抗体滴度≥5倍正常值上限(ULN)时,诊断乳糜泻的敏感度为83.9%、特异度为92.9%;抗tTG抗体滴度≥8倍ULN时,诊断绒毛萎缩的敏感度为67.9%、特异度为90.0%。超过10倍ULN的抗tTG抗体滴度对诊断成年人乳糜泻具有很强的预测价值。该临界值可与临床判断相结合来诊断乳糜泻,这可能有助于避免侵入性内窥镜检查。
To evaluate the association between serum anti-tissue transglutaminase antibody(anti-tTG)titers and the severity of histological damage to the duodenal mucosa and to predict a possible anti-tTG cutoff value for diagnosing celiac disease(CD)and villous atrophy in the domestic population.Clinical and pathological data from 76 adult CD patients with positive anti-tTG titers and duodenal biopsy results who were treated at the People′s Hospital of Xinjiang Uygur Autonomous Region from July 2017 to January 2022 were retrospectively analyzed.The correlation between anti-tTG titers and the severity of duodenal mucosal damage was statistically assessed to predict the optimal anti-tTG titer cut-off value for diagnosing CD and villous atrophy.Of the 76 patients,10 had underlying CD,and of the 66 patients with duodenal histopathology,four were MarshⅠ,six were MarshⅡ,and 56 were MarshⅢa-c grade.In adults with CD,anti-tTG titers were shown to be associated with the severity of histological damage to the duodenal mucosa.When the anti-tTG level was≥5 times the upper limit of normal(ULN),the sensitivity and specificity for diagnosing CD were 83.9%and 92.9%,respectively.When the anti-tTG titer was≥8 times the ULN,the sensitivity and specificity for diagnosing villous atrophy were 67.9%and 90.0%,respectively.Anti-tTG levels had a strong predictive value for diagnosing CD in adults when titers exceeded 10 times the ULN.Thus,the anti-tTG cut-off value can be combined with clinical judgment to diagnose CD,limiting the use of invasive endoscopy.
作者
王曼
卢加杰
李婷
马春婷
李紫琼
阿迪来·阿布都热西提
惠文佳
王春
孙振柱
高峰
Man Wang;Jiajie Lu;Ting Li;Chunting Ma;Ziqiong Li;Adilai·Abudurexiti;Wenjia Hui;Chun Wang;Zhenzhu Sun;Feng Gao(Graduate School of Xinjiang Medical University,Urumqi 830001,China;Department of Gastroenterology,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Xinjiang Clinical Research Center for Digestive Diseases,Urumqi 830001,China;Department of Pathology,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2023年第2期188-192,共5页
Chinese Journal of Internal Medicine
基金
新疆维吾尔自治区自然科学基金(2021D01C149)。
关键词
乳糜泻
血清学
抗体
病理学
Celiac disease
Serology
Antibodies
Pathology
