Knyazev O V, Kagramanova A V, Korneeva I A, Noskova K K, Belousov S V, Parfenov A I
A.S. Loginov Moscow Clinical Research and Practical Center of the Department of Health of Moscow, Moscow, Russia.
Ter Arkh. 2019 May 16;91(4):53-61. doi: 10.26442/00403660.2019.04.000229.
To compare fecal calprotectin (FC) concentration with laboratory and diagnostic methods in patients with inflammatory bowel diseases (IBD).
The level of FC was measured in 110 patients with established IBD. Crohn diseases (CD) was diagnosed in 50 patients, ileocolitis - in 38 and terminal ileitis in 12 individuals. Ulcerative colitis (UC) was diagnosed in 60 patients, total colitis in 35, left-side colitis in 21 and 4 patients have proctitis. Laboratory data include measurement of FC, leukocytes, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), fecal occult blood. All patients underwent colonoileoscopy (CIS) at the start of disease flare and after 12 weeks of treatment.
We found linear correlation between level of FCP and endoscopic activity of CD, analyzing FCP level and endoscopic activity of CD before (during disease flare) and after 12 weeks treatment (r=0.66, p<0.001). Linear correlation between FCP and SES-CD sustained after 12 weeks of treatment (r=0.77, p<0.001). We revealed correlation between FCP concentration. And CRP level (r=0.59, p<0.05). The linear correlation was detected between FCP and endoscopic activity of UC (r=0.88, p<0.001) before the treatment. After 12 weeks of treatment linear correlation was shown between FCP and Meyo scale (r=0.73, p<0.001). IBD patients with FCP more than 200 mcg/g have high risk of disease reccurence in short-term period of time (HR - 8.33; 95% CI 2.05-33.8; χ2 - 11.85; p<0.001) and (HR - 2.7; 95% CI 1.1-6.6; χ2 - 5.3; p<0.05), accordingly.
Increased FCP level indicates poor effectiveness of treatment and high risk of reccurence. The level of FCP correlates strongly with recent laboratory and diagnostic indices of activity and enables to determine patients with high risk of reccurence. Thus, thorough monitoring, including additional procedures, contributes to just-in-time treatment modification.
比较炎症性肠病（IBD）患者粪便钙卫蛋白（FC）浓度与实验室及诊断方法。
对110例确诊为IBD的患者测定FC水平。50例患者诊断为克罗恩病（CD），38例为回结肠型炎症，12例为末端回肠炎。60例患者诊断为溃疡性结肠炎（UC），35例为全结肠炎，21例为左侧结肠炎，4例为直肠炎。实验室数据包括FC、白细胞、红细胞沉降率（ESR）、C反应蛋白（CRP）、粪便潜血的测定。所有患者在疾病发作开始时及治疗12周后均接受结肠镜检查（CIS）。
分析疾病发作期间及治疗12周后CD患者的FCP水平与内镜活动度，发现FCP水平与CD的内镜活动度呈线性相关（r = 0.66，p < 0.001）。治疗12周后FCP与SES - CD仍保持线性相关（r = 0.77，p < 0.001）。我们发现FCP浓度与CRP水平之间存在相关性（r = 0.59, p < 0.05）。治疗前FCP与UC内镜活动度呈线性相关（r = 0.88，p < 0.001）。治疗12周后，FCP与Meyo评分呈线性相关（r = 0.73, p < 0.001）。FCP超过200 mcg/g的IBD患者在短期内疾病复发风险较高（HR - 8.33；95% CI 2.05 - 33.8；χ2 - 11.85；p < 0.001）以及（HR - 2.7；95% CI 1.1 - 6.6；χ2 - 5.3；p < 0.05）。
FCP水平升高表明治疗效果不佳且复发风险高。FCP水平与近期活动度的实验室及诊断指标密切相关，能够确定复发风险高的患者。因此，进行全面监测，包括额外检查，有助于及时调整治疗方案。
