摘要
目的探讨C反应蛋白/白蛋白比值(CRP/Alb)、粪钙卫蛋白(FC)和纤维蛋白原(FIB)联合检测的克罗恩病肠黏膜愈合和复发预测价值。方法对2021年1月~2022年12月收治且达临床愈合(克罗恩病疾病活动指数<150分)的克罗恩病患者106例进行回顾性分析。患者均进行肠镜SES-CD评分评价并分为肠黏膜愈合组(n=47)和非肠黏膜愈合组(n=59)。比较两组患者复发率,并通过诊断性试验四格表分析克罗恩病肠黏膜愈合状况对其复发的预测价值。根据患者复发状况分为复发组(n=31)和非复发组(n=75)。收集比较不同组别患者治疗前后的CRP/ALB、FC、FIB水平,并通过绘制ROC曲线分析CRP/ALB、FC、FIB水平单独和联合预测克罗恩病肠黏膜愈合和复发的效能。结果非肠黏膜愈合组的复发率和治疗前后的CRP/ALB、FC、FIB水平均高于肠黏膜愈合组(P<0.05)。诊断性试验四格表分析结果显示,克罗恩病临床愈合后未肠黏膜愈合预测其复发的敏感度、特异度及准确性分别为80.65%、54.67%和62.26%。复发组治疗前后的CRP/ALB、FC、FIB水平均高于非复发患者(P<0.05)。ROC曲线分析结果显示,治疗前CRP/ALB、FC和FIB联合检测的克罗恩病肠黏膜愈合和复发预测效能均更佳,其曲线下面积分别为0.741和0.839。结论CRP/ALB、FC和FIB均能在一定程度上预测克罗恩病肠黏膜愈合和复发状况,且联合检测的预测效能最佳。
Objective To explore the pvalue of C-reactive protein/albumin ratio(CRP/Alb),fecal calprotectin(FC),and fibrinogen(FIB)combined detection for predicting intestinal mucosal healing and recurrence in Crohn′s disease.Methods A retrospective analysis was conducted on 106 patients with Crohn′s disease who received treatment from January 2021 to December 2022 and achieved clinical healing(Crohn′s disease activity index<150 points).All of the patients underwent colonoscopy SES-CD score evaluation and were divided into intestinal mucosal healing group(n=47)and non-intestinal mucosal healing group(n=59).The recurrence rates of two groups of patients were compared,and the value of intestinal mucosal healing status predicting Crohn′s disease recurrence were analyzed through a diagnostic test four grid table.According to the recurrence status of patients,they were divided into recurrence group(n=31)and non recurrence group(n=75).The CRP/ALB,FC,FIB levels of different groups of patients before and after treatment were collected and compared,and the efficacy of CRP/ALB,FC,FIB levels alone and jointly to predict the intestinal mucosa healing and recurrence of Crohn′s disease were analyzed by drawing receiver operating characteristic curve.Results The recurrence rate and before and after treatment CRP/ALB,FC,FIB levels in the non intestinal mucosal healing group were higher than those in the intestinal mucosal healing group(P<0.05).The diagnostic test four grid analysis results showed that the sensitivity,specificity and accuracy of non intestinal mucosal healing predicting the recurrence of Crohn′s disease after clinical healing were 80.65%,54.67%and 62.26%,respectively.The before and after treatment levels of CRP/ALB,FC,and FIB in the recurrent group were higher than those in non recurrent patients(P<0.05).The results of Receiver operating characteristic analysis showed that the combined detection of before treatment CRP/ALB,FC and FIB was more effective in predicting intestinal mucosal healing and recurrence of Cr
作者
姚潇
马田田
李小洁
高金波
YAO Xiao;MA Tian-tian;LI Xiao-jie;GAO Jin-bo(Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 420022,China)
出处
《现代消化及介入诊疗》
2023年第7期823-827,共5页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
2019年湖北省科技计划项目(19A1270083)。
