Correlations among total colonoscopic findings, clinical symptoms, and laboratory markers in ulcerative colitis
Correlations among total colonoscopic findings, clinical symptoms, and laboratory markers in ulcerative colitis
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DOI：
10.1111/j.1440-1746.2008.05413.x
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发表时间：
2008-12-01
影响因子：
4.1
通讯作者：
Watanabe, Sumio
中科院分区：
文献类型：
--
作者：
Osada, Taro;Ohkusa, Toshifumi;Watanabe, Sumio
结肠镜检查在溃疡性结肠炎（UC）的诊断、治疗和监测中发挥着不可或缺的作用。在本研究中，我们评估了内镜和组织学结果、临床症状和实验室数据之间的关系。我们对 54 名连续 UC 患者进行了全结肠镜检查。对七个节段（阑尾区、盲肠、升结肠、横结肠、降结肠、乙状结肠和直肠）进行内镜和组织学活动评分。还使用症状活动指数和实验室标志物：C反应蛋白（CRP）、红细胞沉降率（ESR）、白细胞（WBC）和血小板（plt）计数对患者进行评估。内镜评分和组织学评分之间（r(s) = 0.738）以及症状活动评分、内镜评分（r(s) = 0.444）和组织学评分（r(s) = 0.557）。尽管远端结肠病变（直肠乙状结肠，内镜：r(s) = 0.515，组织学：r(s) = 0.624）的内镜和组织学评分与临床症状相关，但近端结肠（阑尾区降支；内镜，r(s) = 0.268，组织学，r(s) = 0.329）没有类似的相关性。 CRP、ESR 和 WBC 计数还与内镜和组织学评分总和相关（CRP，r(s) = 0.447，r(s) = 0.369；ESR，r(s) = 0.483，r(s) = 0.589；WBC，r(s) = 0.338，r(s) = 0.330），而血小板计数则不然（r(s) = 0.171，r(s) = 0.210)。特别是，CRP和ESR与近端结肠病变的活动性（CRP，r（s）= 0.474，r（s）= 0.480；ESR，r（s）= 0.423，r（s）= 0.529）密切相关，而不是与远端病变的活动性（CRP，r（s）= 0.236，r（s）= 0.212；ESR， r(s) = 0.368, r(s) = 0.497)。在本研究中，临床症状反映了远端结肠病变的活动性，而CRP和ESR则反映了近端病变的活动性。因此，当临床缓解的 UC 患者 CRP 或 ESR 升高时，可能需要进行全结肠镜检查。
Colonoscopy plays an integral role in the diagnosis, management and surveillance of ulcerative colitis (UC). In the present study we assessed the relationship between endoscopic and histological findings, clinical symptoms, and laboratory data.We performed total colonoscopy examinations in 54 consecutive patients with UC. Seven segments (appendiceal region, cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum) were scored for endoscopic and histological activity. The patients were also evaluated using a symptom-activity index and laboratory markers: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) and platelet (plt) counts.There was a significant positive correlation between endoscopic and histological scores (r(s) = 0.738), and between symptom activity score, endoscopic score (r(s) = 0.444), and histological score (r(s) = 0.557). Although the endoscopic and histological scores of distal colonic lesions (rectum-sigmoid, endoscopic: r(s) = 0.515, histological: r(s) = 0.624) correlated with clinical symptoms, there was no similar correlation for the proximal colon (appendiceal region-descending; endoscopic, r(s) = 0.268, histological, r(s) = 0.329). CRP, ESR, and WBC count also correlated with the sum of endoscopic and histological scores (CRP, r(s) = 0.447, r(s) = 0.369; ESR, r(s) = 0.483, r(s) = 0.589; WBC, r(s) = 0.338, r(s) = 0.330), whereas platelet count did not (r(s) = 0.171, r(s) = 0.210). In partciular, CRP and ESR were well correlated with the activity of proximal colonic lesions (CRP, r(s) = 0.474, r(s) = 0.480; ESR, r(s) = 0.423, r(s) = 0.529) rather than with that of distal lesions (CRP, r(s) = 0.236, r(s) = 0.212; ESR, r(s) = 0.368, r(s) = 0.497).In this study, clinical symptoms reflected the activity of distal colonic lesions, whereas CRP and ESR reflected the activity of proximal lesions. Therefore, total colonoscopy may be indicated when CRP or ESR is elevated in UC patients in clinical remission.