Takeyama Hiroshi, Mizushima Tsunekazu, Iijima Hideki, Shinichiro Shinzaki, Uemura Mamoru, Nishimura Junichi, Hata Taishi, Takemasa Ichiro, Yamamoto Hirofumi, Doki Yuichiro, Mori Masaki
Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita City, Osaka, 565-0871, Japan.
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita City, Osaka, 565-0871, Japan.
Dig Dis Sci. 2015 Nov;60(11):3418-23. doi: 10.1007/s10620-015-3745-2. Epub 2015 Jun 16.
In assessing Crohn's disease (CD) activity, C-reactive protein (CRP) is an important indicator of inflammation; however, it is not necessarily associated with the Crohn's Disease Activity Index (CDAI), particularly in patients with low CRP. Recently, platelet activation factors have been recognized due to their importance in the inflammatory response. In this study, we examined associations between the CDAI and platelet factor 4 (PF-4), β-thromboglobulin (β-TG), and other coagulation and fibrinolysis factors.
We aimed to find a new marker for evaluating disease activity in patients with CD and low CRP.
Nine markers, including CRP, platelet count, white blood cell count, fibrin and fibrinogen degradation product, fibrinogen, thrombin-antithrombin complex, prothrombin fragments 1 + 2, PF-4, and β-TG were evaluated in 47 patients with CD and low CRP (<1.0 mg/dl). Patients were assigned to high or low disease activity groups, CDAI-H (CDAI ≥ 150) and CDAI-L (CDAI < 150), respectively.
CDAI-H exhibited significantly higher PF-4 and β-TG levels than CDAI-L (P < 0.01). Other markers were not significantly different between groups. CDAI was positively correlated with the levels of PF-4 and β-TG (P = 0.0033 and 0.0024; r = 0.4202 and 0.4321, respectively). Receiver operating characteristic curve analyses of PF-4 and β-TG showed high sensitivity (61.9 and 81%, respectively) and specificity (84.7 and 69.2%, respectively) for diagnosing active CD.
Among eight potential markers, PF-4 and β-TG were the most highly correlated with CDAI in patients with CD and low CRP. PF-4 and β-TG levels showed promise as new markers for assessing CD in patients with low CRP.
在评估克罗恩病（CD）活动度时，C反应蛋白（CRP）是炎症的重要指标；然而，它不一定与克罗恩病活动指数（CDAI）相关，尤其是在CRP水平较低的患者中。近年来，血小板激活因子因其在炎症反应中的重要性而受到关注。在本研究中，我们检测了CDAI与血小板因子4（PF-4）、β-血小板球蛋白（β-TG）以及其他凝血和纤溶因子之间的关联。
我们旨在寻找一种用于评估CRP水平较低的CD患者疾病活动度的新标志物。
对47例CRP水平较低（<1.0mg/dl）的CD患者评估了9项指标，包括CRP、血小板计数、白细胞计数、纤维蛋白和纤维蛋白原降解产物、纤维蛋白原、凝血酶-抗凝血酶复合物、凝血酶原片段1+2、PF-4和β-TG。患者分别被分为疾病活动度高或低的组，即CDAI-H（CDAI≥150）组和CDAI-L（CDAI<150）组。
CDAI-H组的PF-4和β-TG水平显著高于CDAI-L组（P<0.01）。其他指标在两组之间无显著差异。CDAI与PF-4和β-TG水平呈正相关（P分别为0.0033和0.0024；r分别为0.4202和0.4321）。PF-4和β-TG的受试者工作特征曲线分析显示，诊断活动性CD具有较高的敏感性（分别为61.9%和81%）和特异性（分别为84.7%和69.2%）。
在8种潜在标志物中，PF-4和β-TG与CRP水平较低的CD患者的CDAI相关性最高。PF-4和β-TG水平有望成为评估CRP水平较低的CD患者病情的新标志物。
