Correlation between Serological Biomarkers and Disease Activity in Patients with Inflammatory Bowel Disease
Correlation between Serological Biomarkers and Disease Activity in Patients with Inflammatory Bowel Disease
复制标题
炎症性肠病患者血清学生物标志物与疾病活动性的相关性
DOI：
10.1155/2019/6517549
复制
发表时间：
2019-12-26
影响因子：
--
通讯作者：
Cao, Qian
中科院分区：
文献类型：
--
作者：
Xu, Mengque;Cen, Mengsha;Cao, Qian
研究背景目前炎症性肠病（IBD）的生物标志物已成为常规的无创性疾病活动性评价方法，但无特异性。本研究旨在确定血清学生物标志物用于检测IBD患者疾病活动性的性能。方法对73例溃疡性疾病（UC）、141例克罗恩病（CD）及其中30例合并CD患者进行前瞻性研究。艰难梭菌感染（CDI）在单一机构IBD中心诊断。UC采用Truelove和Witts标准，CD采用Harvey Bradshaw简单指数评估疾病活动性。在不同严重程度组中比较血清学炎症生物标志物。接受者操作曲线分析评估了每种生物标志物在区分疾病状态中的性能。结果活动期和非活动期UC患者单核细胞计数、C反应蛋白（CRP）升高，淋巴细胞计数和淋巴细胞/单核细胞比值（LMR）降低，差异有统计学意义。LMR为3.1时，对活动性UC的敏感性为76%，特异性为67%。对于CD患者，中性粒细胞、单核细胞、中性粒细胞/淋巴细胞比率、CRP、纤维蛋白原的较高值以及LMR和血红蛋白的较低值在活动性和非活动性CD受试者之间存在显著差异。所包括的生物标志物中没有一个与疾病活动性具有良好的相关性（ROC曲线下面积< 0.70）。结论低LMR代表了一种廉价、易得的检测方法，对确定UC患者的疾病活动性具有很好的价值，而没有一种炎症生物标志物显示出CD疾病活动性的鉴别价值。
Background Current biomarkers have been routinely used noninvasive methods for assessing disease activity of inflammatory bowel disease (IBD), but none of them are specific. This study was aimed to determine the performance of the serological biomarkers for detecting disease activity in patients with IBD. Methods A prospective study that included 73 ulcerative disease (UC) subjects, 141 Crohn's disease (CD) subjects, and 30 of them complicated with C. difficile infection (CDI) were diagnosed at a single-institution IBD center. Disease activity was assessed using by Truelove and Witts criteria for UC and Harvey Bradshaw Simple Index for CD. Serological inflammatory biomarkers were compared in different severity groups. Receiver operator curve analyses assessed the performance of each biomarker in discriminating disease states. Results For UC patients, elevated monocyte counts, C-reactive protein (CRP), and decreased lymphocyte counts and lymphocyte/monocyte ratio (LMR) significantly differed between subjects with active and inactive UC. LMR of 3.1 was 76% sensitive and had a specificity of 67% for active UC. For CD patients, higher values of neutrophils, monocytes, neutrophil/lymphocyte ratio, CRP, fibrinogen, and lower values of LMR and hemoglobin were significantly different between subjects with active and inactive CD. None of the biomarkers included had a good correlation with disease activity (area under the ROC Curve < 0.70). Conclusions A low LMR represents an inexpensive, readily available test with a promising value to identify disease activity in UC patients, whereas none of the inflammatory biomarkers showed a discriminative value in disease activity of CD.