Bonnín Tomàs A, Vila Vidal M, Rosell Camps A
Sección de Bioquímica, Servicio de Análisis Clínicos, Hospital Universitario SOn Dureta, Palma de Mallorca.
Rev Esp Enferm Dig. 2007 Dec;99(12):689-93. doi: 10.4321/s1130-01082007001200002.
There is growing evidence showing the importance of the fecal calprotectin assay in differentiating organic from functional gastrointestinal disease. It is a simple, non-invasive biomarker that is especially useful in children, who may require general anesthesia for colonoscopy. The aim of this study was to assess the use and sensitivity of fecal calprotectin (FCP) in pediatric patients with signs and symptoms of IBD to avoid unnecessary invasive techniques and to distinguish between organic and functional gastrointestinal pathology.
A single stool sample was collected from 47 children (mean age: 10.1 years) referred for non-specific gastrointestinal symptoms suggestive of organicity. On the basis of clinical criteria 13 children had functional bowel disorders and 34 had organic gastrointestinal disease, 15 with IBD and 19 with other organic (non-IBD) gastrointestinal conditions. Thirty healthy children were included as controls. Calprotectin concentrations were measured by enzyme immunoassay.
Children with IBD had FCP levels [median (interquartile range); 1,219 microg/g (322-2,967 microg/g)] higher than children with functional gastrointestinal disease [20 microg/g (16-25 microg/g); p < 0.0001], those with organic non-IBD disease [113 microg/g (36-193 microg/g); p = 0.002], and healthy children [25 microg/g (19.2-32.5 microg/g); p < 0.0001]. Fecal calprotectin concentration also was significantly higher in children with organic (non-IBD) disease as compared to controls (p = 0.004) and children with functional pathology (p = 0.002). FCP levels were similar in controls and children with functional gastrointestinal disease (p = 0.264).
CPF is a sensitive, but not disease-specific, marker to identify patients with IBD who should undergo diagnostic colonoscopy, and to avoid unnecessary invasive procedures in patients with functional gastrointestinal disorders.
越来越多的证据表明，粪便钙卫蛋白检测在区分器质性与功能性胃肠疾病方面具有重要意义。它是一种简单、无创的生物标志物，对可能需要在结肠镜检查时进行全身麻醉的儿童尤为有用。本研究的目的是评估粪便钙卫蛋白（FCP）在患有炎症性肠病（IBD）体征和症状的儿科患者中的应用及敏感性，以避免不必要的侵入性检查，并区分器质性和功能性胃肠病变。
收集了47名因提示器质性病变的非特异性胃肠症状前来就诊的儿童（平均年龄：10.1岁）的单次粪便样本。根据临床标准，13名儿童患有功能性肠病，34名患有器质性胃肠疾病，其中15名患有IBD，19名患有其他器质性（非IBD）胃肠疾病。纳入30名健康儿童作为对照。采用酶免疫测定法测量钙卫蛋白浓度。
IBD患儿的FCP水平[中位数（四分位间距）；1219μg/g（322 - 2967μg/g）]高于功能性胃肠疾病患儿[20μg/g（16 - 25μg/g）；p < 0.0001]、器质性非IBD疾病患儿[113μg/g（36 - 193μg/g）；p = 0.002]以及健康儿童[25μg/g（19.2 - 32.5μg/g）；p < 0.0001]。与对照组（p = 0.004）和功能性病变患儿（p = 0.002）相比，器质性（非IBD）疾病患儿的粪便钙卫蛋白浓度也显著更高。对照组和功能性胃肠疾病患儿的FCP水平相似（p = 0.264）。
CPF是一种敏感但非疾病特异性的标志物，可用于识别应接受诊断性结肠镜检查的IBD患者，并避免对功能性胃肠疾病患者进行不必要的侵入性检查。
