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尿唾液酸排泄升高可作为克罗恩病的新型生物标志物。

Elevated urinary orosomucoid excretion as a novel biomarker in Crohn's disease.

机构信息

Department of Laboratory Medicine, University of Pécs Medical School, Pécs, Hungary.

Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary.

出版信息

Eur J Clin Invest. 2019 Mar;49(3):e13054. doi: 10.1111/eci.13054. Epub 2018 Dec 13.

Abstract

BACKGROUND

Laboratory markers are essential tools in the follow-up of patients with Crohn's disease (CD). Our aim was to investigate urinary concentrations of orosomucoid in relation to the inflammatory activity of CD and to compare it with clinical indices and conventional laboratory parameters.

MATERIALS AND METHODS

Blood and urine samples of 86 patients (55 adults and 31 children) with CD and 68 healthy individuals (38 adults and 30 children) as controls were analysed. Patients were categorized according to their clinical scores (Harvey-Bradshaw Index [HBI] or Pediatric Crohn's Disease Activity Index [PCDAI]). Urinary orosomucoid (u-ORM) was determined by automated immune turbidimetric assay, and values were referred to urinary creatinine (u-ORM/u-CREAT, mg/mmol).

RESULTS

U-ORM/u-CREAT values were seven times higher in children with active CD (0.50 vs 0.07 mg/mmol, P < 0.001) and two times higher in adults (0.32 vs 0.14 mg/mmol, P = 0.01) compared with patients with inactive disease. U-ORM/u-CREAT showed good correlation with conventional inflammatory markers (hs-CRP, serum ORM; P < 0.01) and activity indices (HBI, P = 0.018; PCDAI, P < 0.001). U-ORM/u-CREAT had similar discriminative performance to hs-CRP and serum ORM in the differentiation of active from inactive paediatric CD patients.

CONCLUSIONS

Our findings suggest that u-ORM/u-CREAT might serve as a valuable additional marker in the follow-up of CD patients, especially in children for whom the non-invasive sampling is a further advantage.

摘要

背景

实验室标志物是克罗恩病(CD)患者随访的重要工具。我们的目的是研究尿唾液酸蛋白浓度与 CD 的炎症活动之间的关系,并将其与临床指标和常规实验室参数进行比较。

材料和方法

分析了 86 例 CD 患者(55 例成人和 31 例儿童)和 68 例健康个体(38 例成人和 30 例儿童)的血液和尿液样本。根据临床评分(哈维-布拉德肖指数[HBI]或儿科克罗恩病活动指数[PCDAI])对患者进行分类。尿唾液酸蛋白(u-ORM)通过自动免疫比浊法测定,结果以尿肌酐(u-ORM/u-CREAT,mg/mmol)表示。

结果

与疾病不活跃的患者相比,活动期 CD 患儿的 u-ORM/u-CREAT 值高 7 倍(0.50 比 0.07 mg/mmol,P < 0.001),成人高 2 倍(0.32 比 0.14 mg/mmol,P = 0.01)。u-ORM/u-CREAT 与常规炎症标志物(hs-CRP、血清 ORM;P < 0.01)和活动指数(HBI,P = 0.018;PCDAI,P < 0.001)具有良好的相关性。u-ORM/u-CREAT 在区分活动期和非活动期儿科 CD 患者方面具有与 hs-CRP 和血清 ORM 相似的鉴别性能。

结论

我们的研究结果表明,u-ORM/u-CREAT 可能作为 CD 患者随访的有价值的附加标志物,特别是对于需要非侵入性取样的儿童患者,具有进一步的优势。

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