[抗酿酒酵母抗体和抗中性粒细胞胞浆抗体在非特异性炎症性肠病患者中的应用评估]

[Assessment of usefulness of anti-Saccharomyces cerevisiae and anti-neutrophil cytoplasmic antibodies in patients with unspecific inflammatory bowel diseases].

作者信息

Mokrowiecka Anna, Gasiorowska Anita, Małecka-Panas Ewa

机构信息

Klinika Chorób Przewodu Pokarmowego IMW UM w Lodzi.

出版信息

Pol Merkur Lekarski. 2004;17 Suppl 1:22-6.

PMID:15603341

Abstract

UNLABELLED

Ulcerative colitis (UC) and Crohn's disease (CD) are the nonspecific inflammatory bowel diseases with unknown etiology. Existing diagnostic methods are in many cases insufficient for proper diagnosis and choice of treatment method. In 10% cases of inflammatory bowel disease indeterminate colitis (IC) is described. It includes cases with diverse clinical manifestations, range and histopathological picture. New methods to distinguish inflammatory bowel diseases, chose proper treatment and monitor their activity are searched. Anti-Saccharomyces cerevisiae antibodies (ASCA) and antineutrophil cytoplasmatic antibodies (pANCA) seem to be a new markers used in this end.

OBJECTIVE

Comparison of ASCA and pANCA appearance in CD and UC searching of correlation between serum levels of antibodies, activity and clinical picture of disease and appearance of ASCA and pANCA in IC.

MATERIAL AND METHODS

We examined 63 patients with UC aged 24 to 74 (30 men and 33 women), 14 patients with CD aged 27 to 64 (10 men and 4 women) and 11 patients with IC aged 21 to 53 (4 men and 7 women). Mean duration time of diseases respectively for UC, CD and IC was 7.9 (from 1.0 to 32), 9 (from 1 to 20) and 3.04 (0.5 to 7) years. Diagnosis in specific clinical picture was established with endoscopic and histopathologic examination. Disease activity was described according to Rachmilewitz scale in UC and in CD according to Crohn's disease activity index (CDAI). Control group consisted of 24 healthy men. Examination of pANCA, IgA and IgG ACSA was performed with ELISA kits respectively by Congent Diagnostics and Genesis Diagnostic.

RESULTS

There were 39 of UC patients and of CD patients with active disease according to Rachmilewitz scale (above 3 points) and CDAI. We observed statistically more often pANCA in patients with UC (58%; n=31) than in patients with CD (28%; n=4) (p<0.05). Both IgA and IgG ACSCA occurred more often in patients with CD (57%; n=8) than in patients with UC (24%; n=15) (p<0.05). There were no significant differences between antibodies according to duration time, activity, location and treatment method of diseases. Obtained results besides the help with understanding of pathologic mechanisms, indicate for use of antibodies as an diagnostic tool in inflammatory bowel diseases.

摘要

未标注

溃疡性结肠炎（UC）和克罗恩病（CD）是病因不明的非特异性炎症性肠病。现有诊断方法在很多情况下不足以进行准确诊断和选择治疗方法。在10%的炎症性肠病病例中描述为不确定性结肠炎（IC）。它包括具有不同临床表现、范围和组织病理学表现的病例。正在寻找区分炎症性肠病、选择合适治疗方法并监测其活动的新方法。抗酿酒酵母抗体（ASCA）和抗中性粒细胞胞浆抗体（pANCA）似乎是为此目的而使用的新标志物。

目的

比较CD和UC中ASCA和pANCA的出现情况，寻找抗体血清水平、疾病活动和临床表现之间的相关性以及IC中ASCA和pANCA的出现情况。

材料和方法

我们检查了63例年龄在24至74岁之间的UC患者（30名男性和33名女性）、14例年龄在27至64岁之间的CD患者（10名男性和4名女性）以及11例年龄在21至53岁之间的IC患者（4名男性和7名女性）。UC、CD和IC疾病的平均病程分别为7.9年（1.0至32年）、9年（1至20年）和3.04年（0.5至7年）。通过内镜和组织病理学检查在特定临床表现中确立诊断。UC的疾病活动根据Rachmilewitz量表描述，CD的疾病活动根据克罗恩病活动指数（CDAI）描述。对照组由24名健康男性组成。分别使用Congent Diagnostics和Genesis Diagnostic的ELISA试剂盒检测pANCA、IgA和IgG ACSA。

结果

根据Rachmilewitz量表和CDAI，UC患者和CD患者中有39例患有活动性疾病。我们观察到UC患者中pANCA的出现频率（58%；n = 31）在统计学上高于CD患者（28%；n = 4）（p<0.05）。CD患者中IgA和IgG ACSCA的出现频率（57%；n = 8）均高于UC患者（24%；n = 15）（p<0.05）。根据疾病的病程、活动、部位和治疗方法，抗体之间没有显著差异。除了有助于理解病理机制外，所获得的结果表明抗体可作为炎症性肠病的诊断工具。