JCC: 粪便钙卫蛋白水平可以对溃疡性结肠炎内镜和组织疾病活动进行判断

2019-04-06 不详 MedSci原创

在临床工作中,粪便钙卫蛋白[FCal]水平被用作粘膜炎症的生物标志物,但其在溃疡性结肠炎[UC]中定义内镜或组织学疾病活动的阈值仍不清楚,因此本项研究旨在探究FCal与内镜或组织学疾病活动之间的定量关系。

背景
临床工作中,粪便钙卫蛋白[FCal]水平被用作粘膜炎症的生物标志物,但其在溃疡性结肠炎[UC]中定义内镜或组织学疾病活动的阈值仍不清楚,因此本项研究旨在探究FCal与内镜或组织学疾病活动之间的定量关系。

方法
研究人员使用经过验证的疾病活动指数,FCal的前瞻性测量,症状[简单结肠炎临床活动指数,SCCAI],内镜[溃疡性结肠炎内镜指数严重程度,UCEIS]和组织学活动[Nancy指数]在参加TrueColours UC的患者中进行了6个月以上基于网络的监测试验。缓解和活动性疾病的定义在FCal和SCCAI,UCEIS和Nancy指数之间进行重复测量相关[UCEIS:缓解≤1,活动≥4; 南希:缓解≤1,活动≥2; 综合标准:缓解UCEIS≤1和Nancy≤1,有效UCEIS≥4,Nancy≥2]。使用ROC曲线研究了FCal阈值。

结果
研究人员总共对39名患者进行了6个月的前瞻性随访,FCal与SCCAI,UCEIS和Nancy指数之间的相关系数为0.271(95%可信区间[CI] 0.114-0.415),0.741 [95%CI 0.289-0.922]和0.876 [95] %CI 0.605-0.965]。使用内窥镜,组织学或组合标准进行缓解的中位FCal阈值分别为71μg/ g [范围8-624],91μg/ g [范围8-858]和67μg/ g [范围8-479]。确认活动性疾病的FCal阈值为UCEIS为187μg/ g(曲线下面积[AUC] 0.915),Nancy [AUC 0.824]为72μg/ g,内镜和组织学标准组合为187μg/ g [ AUC 0.936]。

结论
FCal与UC症状之间的相关性较弱。相反,FCal与内镜或组织学活动之间的相关性很强。FCal≥72μg/ g表示组织学炎症[Nancy≥2]且≥187μg/ g表示内镜活动性疾病[UCEIS≥4]。

原始出处:

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    2019-05-08 nymo
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    2019-04-08 Homburg

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