Krzesiek Elzbieta, Iwańczak Barbara
Akademia Medyczna we Wrocławiu, II Katedra i Klinika Pediatrii Gastroenterologii i Zywienia.
Pol Merkur Lekarski. 2010 Oct;29(172):241-6.
Among patients with inflammatory bowel disease children constitute about 15-20%. Still is ongoing search for the perfect marker for this large group of patients which will help in the diagnosis of the disease, in determination of its activity, in monitoring the treatment and in predicting the relapse, while the test for that marker would be simple, cheap and noninvasive. One of the antimicrobial peptide-calprotectin, which is present in feces and is dependent on the number of migrating granulocytes into the intestinal lumen, is a promising marker of the severity of inflammation. The aim of the study was to evaluate the usefulness of the application of calprotectin measurement in stool in children with inflammatory bowel disease, as a marker of the severity of inflammation.
We analyzed 115 patients: 32 with ulcerative colitis (UC), 44 with Crohn's disease (CD), 9 with hemorrhagia from the lower part of the digestive tract, but without inflammatory bowel disease and 30 from the control group. In all patients were measured the concentration of calprotectin in the sample of feces using CALPRO (Calprotectin ELISA test) and markers of inflammation: erythrocyte sedimentation rate (ESR), CRP protein, leukocytosis in the peripheral blood counts (L), concentration of seromucoid and the number of platelets (Tr) and hemoglobin (Hb).
Concentration of calprotectin in feces of patients with inflammatory bowel diseases was above the norm I (> 50 mg/kg b.w.) in all patients with moderate and severe disease and in the majority of patients with mild disease or in remission. In contrast it was normal in all from control group. Fecal calprotectin concentration was higher than normal in connection with abnormal results of laboratory parameters such as inflammatory markers in serum and haemoglobin concentration. Laboratory abnormalities were more frequent in patients with IBD and with fecal calprotectin level above the norm than in all patients with IBD.
在炎症性肠病患者中，儿童约占15 - 20%。目前仍在寻找适用于这一大组患者的理想标志物，以辅助疾病诊断、确定疾病活动度、监测治疗效果及预测复发，且该标志物检测应简便、廉价且无创。抗菌肽钙卫蛋白是存在于粪便中且依赖于迁移至肠腔的粒细胞数量的一种物质，它是炎症严重程度的一个有前景的标志物。本研究旨在评估检测粪便中钙卫蛋白作为炎症性肠病患儿炎症严重程度标志物的应用价值。
我们分析了115例患者，其中32例为溃疡性结肠炎（UC），44例为克罗恩病（CD），9例为消化道下段出血但无炎症性肠病患者，30例为对照组。对所有患者使用CALPRO（钙卫蛋白酶联免疫吸附试验）检测粪便样本中钙卫蛋白的浓度，并检测炎症标志物：红细胞沉降率（ESR）、CRP蛋白、外周血白细胞计数（L）、血清类粘蛋白浓度、血小板计数（Tr）及血红蛋白（Hb）。
炎症性肠病患者中，所有中度和重度患者以及大多数轻度疾病或缓解期患者粪便中钙卫蛋白浓度高于正常范围I（>50mg/kg体重）。相比之下，对照组所有患者的钙卫蛋白浓度均正常。粪便钙卫蛋白浓度高于正常与血清炎症标志物及血红蛋白浓度等实验室参数异常结果相关。炎症性肠病患者且粪便钙卫蛋白水平高于正常范围者的实验室异常情况比所有炎症性肠病患者更常见。
