Additional benefit of procalcitonin to C-reactive protein to assess disease activity and severity in Crohn's disease
Additional benefit of procalcitonin to C-reactive protein to assess disease activity and severity in Crohn's disease
复制标题
DOI：
10.1111/j.1365-2036.2010.04459.x
复制
发表时间：
2010-11-01
影响因子：
7.6
通讯作者：
Peyrin-Biroulet, L.
中科院分区：
文献类型：
--
作者：
Oussalah, A.;Laurent, V.;Peyrin-Biroulet, L.
血清降钙素原水平可反映非感染性炎症。目的评价血清降钙素原水平与炎症性肠病（IBD）患者疾病活动性的临床、生物学、内镜及影像学指标的相关性，并评价血清降钙素原水平与c反应蛋白（CRP）在疾病活动性评价中的附加诊断价值。方法采用前瞻性观察性研究。Spearman秩相关和受者工作特征分析分别评价相关性和诊断准确性。结果克罗恩病（CD）患者（30例）血清降钙素原水平与临床、生物学、内镜和放射学疾病活动性指标密切相关。在CD中，血清降钙素原水平> 0.14 μ g/L对严重疾病的检测具有较高的准确性（灵敏度= 100%；特异性= 96%;AUROC = 0.963; P = 0.0001）。“血清降钙素原-CRP策略”（CRP水平> 5 mg/L，血清降钙素原水平> 0.05 mu g/L）诊断重症CD的准确率明显优于单纯使用CRP （AUROC = 0.783 vs. 0.674, P = 0.01）。溃疡性结肠炎（UC） （n = 27）患者血清降钙素原水平与CRP及内镜和放射学疾病活动性标志物相关。结论在CD中，血清降钙素原水平与所有疾病活动指标相关，截止值为0.14 μ g/L可区分严重的疾病形式。“血清降钙素原水平-CRP策略”在诊断活动性或重度CD方面优于单独使用CRP。
P>BackgroundSerum procalcitonin level may reflect non-infectious inflammation.AimTo assess the correlation of serum procalcitonin level with clinical, biological, endoscopic and radiological markers of disease activity in inflammatory bowel diseases (IBD), and to evaluate the additional diagnostic benefit of measuring serum procalcitonin level to that of C-reactive protein (CRP) for disease activity appraisal.MethodsWe performed a prospective observational study. Spearman's rank correlation and receiver operating characteristic analysis were used to evaluate correlation and diagnostic accuracy respectively.ResultsIn Crohn's disease (CD) (n = 30), serum procalcitonin level was strongly correlated with clinical, biological, endoscopic and radiological disease activity markers. In CD, the serum procalcitonin level > 0.14 mu g/L demonstrated a high accuracy for detecting severe disease (Sensitivity = 100%; Specificity = 96%; AUROC = 0.963; P = 0.0001). The diagnostic accuracy of the 'serum procalcitonin level-CRP strategy' (CRP > 5 mg/L and serum procalcitonin level > 0.05 mu g/L) was significantly superior to that of CRP alone for diagnosing severe CD (AUROC = 0.783 vs. 0.674; P = 0.01). In ulcerative colitis (UC) (n = 27), serum procalcitonin level was correlated with CRP and with endoscopic and radiological disease activity markers.ConclusionsIn CD, the serum procalcitonin level was correlated with all disease activity markers and a cut-off of 0.14 mu g/L could distinguish severe forms of the disease. The 'serum procalcitonin level-CRP strategy' was superior to CRP alone for diagnosing active or severe CD.