The Crohn's disease activity index (CDAI) is similarly elevated in patients with Crohn's disease and in patients with irritable bowel syndrome
The Crohn's disease activity index (CDAI) is similarly elevated in patients with Crohn's disease and in patients with irritable bowel syndrome
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DOI：
10.1111/apt.12262
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发表时间：
2013-04-01
影响因子：
7.6
通讯作者：
Cheifetz, A. S.
中科院分区：
文献类型：
--
作者：
Lahiff, C.;Safaie, P.;Cheifetz, A. S.
虽然克罗恩病活动指数（CDAI）是克罗恩病（克罗恩病）临床试验中定义临床终点的金标准，但其区分炎症症状和非炎症症状的能力受到质疑。目的比较克罗恩病与肠易激综合征（IBS）患者CDAI评分的差异。方法：这是一项前瞻性、横断面队列研究，纳入91例克罗恩病（n=44）或IBS（n=47）患者。记录总CDAI和单个组分评分，并在克罗恩病和IBS患者之间进行比较。结果IBS患者的CDAI平均评分较高（183 vs. 157，P=0.1）。62%（n=29）的IBS患者CDAI评分大于150。克罗恩病组的平均CDAI红细胞压积评分（35.9 vs. 23.0，P=0.02）和CRP水平（6.8 vs. 2.0，P=0.002）较高。CDAI子评分分析表明，IBS患者的疼痛评分（平均1.7 vs. 0.8，P=0.0007）和健康评分（平均1.2 vs. 0.8，P=0.04）显著高于克罗恩病患者。具体评价CDAI大于150的患者（n=51），IBS患者的疼痛分项评分较高（平均值2.4 vs. 1.4，P=0.002），而克罗恩病患者的CRP较高（平均值8.4 vs. 1.8，P=0.001）。结论我们的研究表明，CDAI不能区分活动性克罗恩病患者和IBS患者。IBS患者的CDAI评分可在有临床意义的范围内。CDAI红细胞压积评分和CRP等客观指标是更特异的炎症标志物。
Background While the Crohn's disease activity index (CDAI) is the gold standard for defining clinical endpoints in Crohn's disease (Crohn's) clinical trials, its ability to distinguish symptoms due to inflammation from those that are non-inflammatory has been questioned. Aim To compare CDAI scores in patients with Crohn's and those with Irritable Bowel Syndrome (IBS). Methods This was a prospective, cross-sectional cohort study of 91 patients with either Crohn's (n=44) or IBS (n=47). Total CDAI and individual component scores were recorded and comparisons were made between Crohn's and IBS patients. Results Mean CDAI scores were higher in the IBS patients (183 vs. 157, P=0.1). Sixty-two per cent (n=29) of IBS patients had CDAI scores greater than 150. Mean CDAI haematocrit score (35.9 vs. 23.0, P=0.02) and CRP level (6.8 vs. 2.0, P=0.002) were higher in the Crohn's group. Analysis of CDAI sub-scores demonstrated that IBS patients had significantly higher pain (mean 1.7 vs. 0.8, P=0.0007) and well-being scores (mean 1.2 vs. 0.8, P=0.04) relative to patients with Crohn's. Specifically evaluating patients with CDAI greater than 150 (n=51), IBS patients had higher pain sub-scores (mean 2.4 vs. 1.4, P=0.002), whereas patients with Crohn's had higher CRP (mean 8.4 vs. 1.8, P=0.001). Conclusions Our study demonstrates that the CDAI does not discriminate patients with symptoms due to active Crohn's from patients with IBS. Patients with IBS can have CDAI scores in the clinically meaningful range. Objective measures, such as CDAI haematocrit score and CRP, are more specific markers of inflammation.