[血清学标志物在炎症性肠病中的意义。约105例研究]

[Interest of serologic markers in inflammatory bowel disease. About 105 cases].

作者信息

Fekih Monia, Ben Hlima Sameh, Zitouni Mondher, Matri Samira, Boubaker Jalel, Makni Soundes, Azza Filali

机构信息

Service de Gastro entérologie A, Hopital la Rahta.

出版信息

Tunis Med. 2007 Oct;85(10):821-8.

PMID:18236802

Abstract

BACKGROUND

The serum markers ASCA and pANCA can help the clinician in certain difficult situations of colites in IBD. The aim of this study was to determine the sensitivity and the specificity of each one of these markers and to establish the characteristics of the positive patients for each one.

METHODS

We included patients having a Crohn's disease (CD) or an ulcerative colitis (UC). These patients was compared to a control group.

RESULTS

80 CD patients with an average age of 35.62 years, 25 UC cases with an average age of 34.92 years and 79 healthy subjects with an average age of 34.2 years were included. The ASCA were detected in 33.8% of CD cases , 8% of UC cases of RCH and 2.5% of contro group (p < 000.1). The pANCA were detected in 48% of UC cases, 27.5% of CD patients and 1.3% of controls (p < 000.1). The sensitivity and the specificity of the ASCA and the pANCA for the diagnosis respectively of CD and UC were 33.8%, 97.5% and of 48%, 97.8%. During the CD, the positivity of the ASCA was significantly associated with ileal location (p = 0.001), with the sténosant and/or fistulisant phenotyp of the disease (p = 0.006), the young age at the time of the diagnosis of the CD (p = 0.067) and at a greater frequency of surgical treatment (p = 00.7). The pANCA were more frequently found in colic location of CD (p = 0.09). During UC, the positivity of the pANCA was not associated with the sex, age, loca tion of the disease, medical treatment nor chiurgical treatment.

CONCLUSION

The ASCA and pANCA are useful during some clinical situations such as differentiation between IBD otherss colitis and to distinguish CD from UC.

摘要

背景

血清标志物抗酿酒酵母抗体（ASCA）和抗中性粒细胞胞浆抗体（pANCA）可在炎症性肠病（IBD）的某些艰难结肠炎病例中帮助临床医生。本研究的目的是确定这些标志物各自的敏感性和特异性，并确定每种标志物阳性患者的特征。

方法

我们纳入了患有克罗恩病（CD）或溃疡性结肠炎（UC）的患者。这些患者与一个对照组进行比较。

结果

纳入了80例平均年龄为35.62岁的CD患者、25例平均年龄为34.92岁的UC病例和79例平均年龄为34.2岁的健康受试者。ASCA在33.8%的CD病例、8%的RCH的UC病例和2.5%的对照组中被检测到（p<0.001）。pANCA在48%的UC病例、27.5%的CD患者和1.3%的对照组中被检测到（p<0.001）。ASCA和pANCA分别对CD和UC诊断的敏感性和特异性为33.8%、97.5%以及48%、97.8%。在CD期间，ASCA的阳性与回肠部位显著相关（p = 0.001），与疾病的狭窄和/或瘘管表型相关（p = 0.006），CD诊断时的年轻年龄（p = 0.067）以及更高的手术治疗频率相关（p = 0.007）。pANCA在CD的结肠部位更常见（p = 0.09）。在UC期间，pANCA的阳性与性别、年龄、疾病部位、药物治疗或手术治疗均无关。