發(fā)布時(shí)間：2018-06-06 14:37

  本文選題：克羅恩病 + 糞便鈣衛(wèi)蛋白�。� 參考：《蘇州大學(xué)》2016年碩士論文

【摘要】：【目的】目前國內(nèi)關(guān)于克羅恩病(Crohn’S disease,CD)患者的糞便鈣衛(wèi)蛋白(fecal calprotectin,FC)與簡(jiǎn)化克羅恩病內(nèi)鏡評(píng)分標(biāo)準(zhǔn)(SESCD)、血清學(xué)指標(biāo)、CDAI之間的相關(guān)性研究以及其對(duì)克羅恩病病情評(píng)估能力等方面的研究較少。本研究的主要目的:一是評(píng)估糞便鈣衛(wèi)蛋白和SESCD、血清學(xué)指標(biāo)和CDAI之間的相關(guān)性。二是研究糞便鈣衛(wèi)蛋白對(duì)克羅恩病病情評(píng)估的能力�！痉椒ā恳晕以合�化科在2013年11月份至2016年1月份收治的資料完整的克羅恩病患者為研究對(duì)象。記錄每例研究對(duì)象的基本情況、病史、血清學(xué)檢查、糞便鈣衛(wèi)蛋白濃度、內(nèi)鏡檢查、影像學(xué)檢查信息,共20例。將數(shù)據(jù)錄入SPSS17.0 for Windows軟件進(jìn)行統(tǒng)計(jì)學(xué)處理。【結(jié)果】1.FC、CDAI、CRP、WBC、ESR、PLT、HB、ALB區(qū)分克羅恩病緩解期與活動(dòng)期的能力:根據(jù)SESCD評(píng)分將患者分為2組:疾病活動(dòng)組(SESCD3),15例(75%),疾病非活動(dòng)組(SESCD≤3)5例(25%)。疾病活動(dòng)組FC、CDAI、CRP、WBC、ESR、PLT中位數(shù)(四分位間距)分別為1800(IQR1000-1800)ug/g、213(100-350)、25(11-73.4)mg/L、6.4(5.1-7.5)×109/L、25(12-41)mm/H、315(235-370)×109/L,明顯高于疾病非活動(dòng)組的105(62-221)ug/g、71.1(60.5-104.1)、6.8(3.65-7.2)mg/L、4.6(3.3-6)×109/L、6(5-8.5)mm/H、273(167-312.5)×109/L,除PLT外差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。疾病活動(dòng)組HB、ALB水平低于疾病非活動(dòng)組,但無統(tǒng)計(jì)意義上的差異(P0.05)。2.FC、CDAI、CRP、WBC、ESR、PLT、HB、ALB區(qū)分疾病非活動(dòng)期、輕度活動(dòng)期、中重度活動(dòng)期的能力:將分組細(xì)化為疾病非活動(dòng)組(SESCD≤3)5例(25%),輕度活動(dòng)組(4-10分)4例(20%),中重度活動(dòng)組(≥11分)11例(55%)。進(jìn)行3組之間的兩兩比較發(fā)現(xiàn),只有FC在非活動(dòng)期與輕度活動(dòng)期(P0.017)、輕度活動(dòng)期與中重度活動(dòng)期之間有差別(P0.017)。3.spearman’s等級(jí)相關(guān)分析:SESCD與FC、CDAI、CRP、WBC、ESR、ALB的spearman’s等級(jí)相關(guān)系數(shù)分別為0.934、0.42、0.49、0.529、0.725、-0.454,均有統(tǒng)計(jì)學(xué)意義上的相關(guān)性(P0.05)。與SESCD的相關(guān)強(qiáng)度依次是FC、ESR、WBC、CRP、ALB、CDAI。而SESCD和PLT、HB無統(tǒng)計(jì)學(xué)意義上的相關(guān)性(P0.05)。FC與CDAI、CRP、WBC、ESR、ALB的spearman’s等級(jí)相關(guān)系數(shù)分別為0.466、0.583、0.574、0.678、-0.394,均有統(tǒng)計(jì)學(xué)意義上的相關(guān)性(P0.05),相關(guān)強(qiáng)度依次是ESR、CRP、WBC、CDAI、ALB。而FC和PLT、HB無統(tǒng)計(jì)學(xué)意義上的相關(guān)性(P0.05)。4.FC、ESR、CRP、CDAI、WBC、ALB預(yù)測(cè)內(nèi)鏡下疾病活動(dòng)的準(zhǔn)確性:ROC曲線分析顯示FC、ESR、CRP、CDAI、WBC、ALB曲線下面積依次是1、0.94、0.913、0.867、0.833、0.84,與0.5相比具有統(tǒng)計(jì)學(xué)差異(P0.05)。ROC曲線分析得出的FC、ESR、CRP、CDAI、WBC、ALB預(yù)測(cè)內(nèi)鏡下疾病活動(dòng)的最佳截點(diǎn)值依次是221ug/g、11mm/H、9.15mg/L、141、5.05×109/L、40.95g/L�！窘Y(jié)論】1.FC、CDAI、CRP、WBC、ESR均能預(yù)測(cè)內(nèi)鏡下克羅恩病的活動(dòng)性炎癥,預(yù)測(cè)內(nèi)鏡下疾病活動(dòng)性炎癥的準(zhǔn)確性大小依次是FC、ESR、CRP、CDAI、WBC。FC、ESR、CRP、CDAI、WBC預(yù)測(cè)內(nèi)鏡下疾病的活動(dòng)性炎癥的最佳截點(diǎn)值依次是221ug/g、11mm/H、9.15mg/L、141、5.05×109/L。2.在FC、CDAI、CRP、WBC、ESR中,只有FC在疾病非活動(dòng)期與輕度活動(dòng)期、輕度活動(dòng)期與中重度活動(dòng)性期之間有差別。3.與SESCD評(píng)分相關(guān)性最強(qiáng)的是FC,然后依次是ESR、WBC、CRP、ALB、CDAI。
[Abstract]:[Objective] at present, there are few studies on the fecal caldin (fecal calprotectin, FC) in Crohn 'S disease (CD) patients with the simplified endoscopic score standard for Crohn's disease (SESCD), the correlation between the serological index, CDAI and the ability to assess the disease condition of Crohn's disease. The first is to assess the correlation between fecal caldin and SESCD, serological indicators and CDAI. Two is the ability to evaluate the assessment of Crohn's disease by faecal caldin. [Methods] a complete group of Crohn patients from November 2013 to January 2016 in our hospital were studied. Basic conditions, medical history, serological examination, fecal caldin concentration, endoscopy, and imaging information, 20 cases. The data were recorded in SPSS17.0 for Windows software for statistical processing. [results] 1.FC, CDAI, CRP, WBC, ESR, PLT, HB, ALB differentiated the ability of Crohn's remission and activity: the patients were divided into 2 groups according to the SESCD score: The disease active group (SESCD3), 15 (75%), and 5 cases (25%) of the disease non active group (SESCD < 3). The median of the disease active group FC, CDAI, CRP, WBC, ESR, and PLT (four) are 1800 (IQR1000-1800) ug/g, 213 (100-350), 25 (11-73.4) mg/L, 6.4 (12-41), 25 (12-41) * * *, obviously higher than those of the disease non activity group /g, 71.1 (60.5-104.1), 6.8 (3.65-7.2) mg/L, 4.6 (3.3-6) x 109/L, 6 (5-8.5) mm/H, 273 (167-312.5) x 109/L, except PLT heterodyne (P0.05). The ability of moderate and severe active period: 5 cases (SESCD < 3) was divided into 5 cases (25%), 4 cases (20%) of mild activity group (20%), and 11 cases (55%) in moderate and severe activity group (55%). The results of 3 groups were found, only FC was in the inactive and mild period (P0.017), and there was a difference between mild and moderate and severe active period (P (0.017).3.spearman 's level correlation analysis: SESCD and FC, CDAI, CRP, WBC, ESR, ALB Spearman' s rank correlation coefficient respectively. P0.05, CDAI, CRP, WBC, ESR, ALB Spearman 's grade correlation coefficients are 0.466,0.583,0.574,0.678, -0.394, and there are statistical correlations (P0.05). ROC curve analysis shows that FC, ESR, CRP, CDAI, WBC, the area under the ALB curve is 1,0.94,0.913,0.867,0.833,0.84, compared with 0.5, there is a statistical difference (P0.05).ROC curve analysis. /L. [Conclusion] 1.FC, CDAI, CRP, WBC, ESR can predict the active inflammation of the endoscopic Crohn's disease. The accuracy of predicting the accuracy of active inflammation in endoscopy is FC, ESR, CRP, CDAI, WBC.FC. In FC, CDAI, CRP, WBC, and ESR, only FC was in the period of disease inactivity and mild activity, and there was a difference between.3. and SESCD score between the mild and moderate and severe active stages, and FC was the strongest, followed by ESR, WBC, CRP, and SESCD.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R574.62

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