Hyams J S, Mandel F, Ferry G D, Gryboski J D, Kibort P M, Kirschner B S, Griffiths A M, Katz A J, Boyle J T
Division of Pediatric Gastroenterology & Nutrition, Harford Hospital, CT 06115.
J Pediatr Gastroenterol Nutr. 1992 Feb;14(2):216-22. doi: 10.1097/00005176-199202000-00017.
The Pediatric Crohn's Disease Activity Index (PCDAI) has been proposed as a simple instrument to aid in the classification of patients by disease severity. The PCDAI includes subjective patient reporting of symptoms, physical examination, nutritional parameters, and several common laboratory tests (hematocrit, erythrocyte sedimentation rate, albumin). In this report we examine the relationship of each of the laboratory parameters to the PCDAI, as well as to a modified Harvey-Bradshaw Index score and physician global assessment of disease activity. Data were gathered from the clinical and laboratory observations from 133 children and adolescents at 12 pediatric gastroenterology centers in North America. A statistically significant relationship (p less than 0.05) was noted between each of the laboratory tests and the PCDAI for patients with either disease limited to the small bowel or in those with colonic involvement. For patients with disease limited to the small bowel, a statistically significant (p less than 0.05) relationship was also noted between the three laboratory parameters and the modified Harvey-Bradshaw Index and global assessment. For patients with large-bowel involvement, the erythrocyte sedimentation rate was statistically related to the modified Harvey-Bradshaw Index and global assessment (p less than 0.01), as was hematocrit to global assessment (p less than 0.01). Although the laboratory parameters used in the PCDAI appear to generally reflect disease activity in most patients, no single laboratory test is adequate to reflect disease activity in all patients. Future work will need to identify additional laboratory measures to reflect the inflammatory process and serve as important adjuncts in the assessment of disease activity.
小儿克罗恩病活动指数（PCDAI）已被提议作为一种简单工具，以协助按疾病严重程度对患者进行分类。PCDAI包括患者对症状的主观报告、体格检查、营养参数以及多项常见实验室检查（血细胞比容、红细胞沉降率、白蛋白）。在本报告中，我们研究了每个实验室参数与PCDAI的关系，以及与改良的哈维 - 布拉德肖指数评分和医生对疾病活动的整体评估之间的关系。数据收集自北美12个儿科胃肠病中心的133名儿童和青少年的临床及实验室观察结果。对于病变局限于小肠或累及结肠的患者，每项实验室检查与PCDAI之间均存在统计学显著关系（p小于0.05）。对于病变局限于小肠的患者，三项实验室参数与改良的哈维 - 布拉德肖指数及整体评估之间也存在统计学显著关系（p小于0.05）。对于累及大肠的患者，红细胞沉降率与改良的哈维 - 布拉德肖指数及整体评估存在统计学相关性（p小于0.01），血细胞比容与整体评估也存在统计学相关性（p小于0.01）。尽管PCDAI中使用的实验室参数似乎总体上能反映大多数患者的疾病活动，但没有单一的实验室检查足以反映所有患者的疾病活动。未来的工作需要确定额外的实验室指标来反映炎症过程，并作为评估疾病活动的重要辅助手段。
