[1]张宪波,刘月皎,陈云峰.粪便钙卫蛋白在肠易激综合征和炎症性肠病鉴别诊断中的意义分析[J].现代检验医学杂志,2021,36(01):124-127.[doi:10.3969/j.issn.1671-7414.2021.01.031]
　ZHANG Xian-bo,LIU Yue-jiao,CHEN Yun-feng.Significance of Fecal Calprotectin in Differential Diagnosis of Irritable Bowel Syndrome and Inflammatory Bowel Disease[J].Journal of Modern Laboratory Medicine,2021,36(01):124-127.[doi:10.3969/j.issn.1671-7414.2021.01.031]
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粪便钙卫蛋白在肠易激综合征和炎症性肠病鉴别诊断中的意义分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年01期
页码:
124-127
栏目:
检验与临床
出版日期:
2021-02-05

文章信息/Info

Title:
Significance of Fecal Calprotectin in Differential Diagnosis of Irritable Bowel Syndrome and Inflammatory Bowel Disease
文章编号:
1671-7414（2021）01-124-04
作者:
张宪波; 刘月皎; 陈云峰
（南京中医药大学附属江苏省中医院检验科，南京 210029）
Author(s):
ZHANG Xian-bo;  LIU Yue-jiao;  CHEN Yun-feng
（Department of Clinical Laboratory, Jiangsu Provincial Hospital of TCM Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing 210029，China）
关键词:
粪便钙卫蛋白; 肠易激综合征; 炎症性肠病; 鉴别
分类号:
R574；R446.13
DOI:
10.3969/j.issn.1671-7414.2021.01.031
文献标志码:
A
摘要:
目的　探讨粪便钙卫蛋白（ fecal calprotectin,FC）在肠易激综合征（ irritable bowel syndrome，IBS）和炎症性肠病（ in.ammatory bowel disease,IBD）鉴别诊断中的意义。方法　选择 2018年 1月～ 7月江苏省中医院门诊及病房收治的 IBS患者 38例，IBD患者 114例。IBD病例中包含溃疡性结肠炎 (ulcerative colitis,UC)63例，克罗恩病 (Crohn’s disease,CD)51例。收集同期健康体检者 55例作为健康对照。采用酶联免疫吸附试验（ ELISA）测定 FC水平，并同时检测 IBD患者红细胞沉降率（ ESR）及 C反应蛋白（ CRP），分析各组之间 FC水平差异，以及 FC，ESR和 CRP与疾病活动指数的相关性。结果　IBD患者 FC水平显著高于 IBS组及健康对照组 , 差异有统计学意义（ q=15.897,18.523，均 P <0.01），UC组 FC水平高于 CD组，差异有统计学意义（ q=5.204，P <0.01）；IBS组 FC水平和健康组相比，差异无统计学意义（ q=0.318，P >0.05）。受试者工作曲线（ ROC）分析显示 FC升高的临界值为 159.5μg/g，对应诊断 IBD的最佳灵敏度和特异度分别为 91.2%和 94.7%。UC组 FC，ESR和 CRP与 Mayo评分均呈正相关性（ r=0.851，0.752和 0.531，均 P <0.01）;CD组 FC，ESR和 CRP与克罗恩病活动指数（ CDAI）评分相关系数均呈正相关性（ r=0.796，0.693和 0.476, 均 P <0.01)。活动期 UC和 CD组患者经过治疗后，FC水平显著降低（t=17.543，11.313，均 P <0.01）。结论　 FC可作为鉴别 IBS和 IBD以及判断 IBD活动性和疗效的一个良好指标。

参考文献/References:

[1] DEFREES D N, BAILEY J. Irritable bowel syndrome: epidemiology, pathophysiology, diagnosis, and treatment[J]. Primary Care, 2017, 44(4):655-671.
[2] POPA S L, LEUCUTA D C, DUMITRASCU D L. Pressure management as an occupational stress risk factor in irritable bowel syndrome: A cross-sectional study[J]. Medicine, 2018, 97(49): e13562.
[3] AYLING R M, KOK K. Fecal calprotectin[J]. Advances in Clinical Chemistry, 2018, 87: 161-190.
[4] BROOKES M J, WHITEHEAD S, GAYA D R, et al. Practical guidance on the use of faecal calprotectin[J]. Frontline Gastroenterology, 2018, 9(2): 87-91.
[5] DAI Cong, JIANG Min, SUN Mingjun. Fecal markers in the management of in.ammatory bowel disease[J]. Postgraduate Medicine, 2018, 130(7): 597-606.
[6] 中华医学会消化病学分会炎症性肠病学组．炎症性肠病诊断与治疗的共识意见 (2018年·北京 )[J]．中华消化杂志，2018, 38 (5): 292-311. Inflammatory Bowel Disease Group, Chinese Society of Gastroenterology, Chinese Medical Association. Chinese consensus on diagnosis and treatment of inflammatory bowel disease (Beijing, 2018) [J]. Chinese Journal of Digestion, 2018, 38 (5): 292-311.
[7] VIVINUS-NéBOT M, FRIN-MATHY G, BZIOUEC-HE H, et al. Functional bowel symptoms in quiescent in.ammatory bowel diseases: role of epithelial barrier disruption and low-grade inflammation[J]. Gut, 2014, 63(5): 744-752.
[8] JONSSON N, NILSEN T, GILLE-JOHNSON P, et al. Calprotectin as an early biomarker of bacterial infections in critically ill patients: an exploratory cohort assessment[J]. Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine, 2017, 19(3): 205-213.
[9] D’HAENS G, FERRANTE M, VERMEIRE S, et al. Fecal calprotectin is a surrogate marker for endoscopic lesions in in.ammatory bowel disease[J]. In.ammatory Bowel Diseases, 2012, 18(12): 2218-2224.
[10] 朱益佳 , 宁明哲 , 杨平 , 等 .血清炎症性肠病抗体谱的检测对 IBD诊断及鉴别诊断的临床价值 [J]．现代检验医学杂志 , 2017, 32(1):141-143. ZHU Yijia,NING Mingzhe,YANG Ping, et al. Clinical value of diagnosis and differential diagnosis of detection of serum inflammatory bowel disease antibody spectrum in IBD[J].Journal of Modern Laboratory Medicine, 2017,32(1):141-143.
[11] GECSE K B, BRANDSE J F, VAN WILPE S, et al. Impact of disease location on fecal calprotectin levels in Crohn’s disease[J]. Scandinavian Journal of Gastroenterology, 2015, 50(7): 841-847.
[12] LOPES S, ANDRADE P, AFONSO J, et al. Monitoring Crohn’s disease activity: endoscopy, fecal markers and computed tomography enterography[J]. Therapeutic Advances in Gastroenterology, 2018, 11: 1756284818769075.
[13] PUOLANNE A M, KOLHO K L, ALFTHAN H, et al. Rapid fecal calprotectin test and symptom index in monitoring the disease activity in colonic in.ammatory bowel disease[J]. Digestive Diseases and Sciences, 2017, 62(11): 3123-3130.
[14] FADEEVA N A, KORNEEVA I A, KNYAZEV O V, et al. Biomarkers of in.ammatory bowel disease activity[J]. Terapevticheskii Arkhiv, 2018, 90(12): 107-111.
[15] 曾俊祥 , 吕婕 , 罗婷 , 等 .粪便钙卫蛋白检测及其实验影响因素 [J].临床检验杂志 ,2019,37(10):756-759. ZENG Junxiang,Lü Jie,LUO Ting, et al.Detection of fecal calprotectin and its experimental influencing factors[J]. Chinese Journal of Clinical Laboratory Science,2019,37(10):756-759.

备注/Memo

备注/Memo:
作者简介：张宪波（1984-），男，大学本科，研究方向：医学免疫学， E-mail:402751551@qq.com。
通讯作者：陈云峰，副主任技师，E-mail: 438854599@qq.com。
更新日期/Last Update: 2021-02-05