Kim Ka Young, Lee Hae Kyung, Kim Hyunjung, Kim Yeongsic, Kim Yonggoo, Choi Hyun Ho, Kim Sang Woo, Kim Hyung Keun, Chae Hiun Suk
Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Laboratory Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Medicine (Baltimore). 2020 Jun 5;99(23):e20539. doi: 10.1097/MD.0000000000020539.
Colon ischemia (CI) is the most common ischemic disorder of the gastrointestinal tract. Although some markers of CI, such as procalcitonin and alkaline phosphatase, have been reported, few specific serum markers have been identified. We investigated whether serum stromal cell-derived factor-1 (SDF-1) is a specific marker of CI and clarified the relationship between serum SDF-1 level and CI according to a history of combined chronic cardiovascular disease (CVD).We measured SDF-1 level and other serological markers in 84 patients (control, n = 20; CI without chronic CVD, n = 21; chronic CVD without CI, n = 20; CI with chronic CVD, n = 23).Patients with CI were older than those without CI. There were more women in the CI groups than those without CI. At admission, SDF-1 level was significantly higher in patients having CI with chronic CVD (P < .001) than in other groups. SDF-1 level was significantly higher at admission than at discharge in patients having CI with chronic CVD (P < .001) but not in patients having CI without chronic CVD. SDF-1 level did not differ according to symptoms, involved sites, or duration of hospitalization. At a cutoff value of 0.5 pg/mL for the SDF-1 level in patients having CI with chronic CVD, the sensitivity and specificity for SDF-1 were 91.3% and 95%, respectively. The area-under-the-curve (AUC) value was 0.95. In the logistic regression analysis, an elevation of the SDF-1 level to >0.5 pg/mL was a significant indicator of CI with chronic CVD [odds ratio (OR), 114.914; 95% confidence interval, 10.51 to >999.999; P < .001].SDF-1 could be a useful early biomarker for the diagnosis of CI in patients with chronic CVD.
结肠缺血（CI）是胃肠道最常见的缺血性疾病。尽管已经报道了一些CI的标志物，如降钙素原和碱性磷酸酶，但很少有特异性血清标志物被确定。我们研究了血清基质细胞衍生因子-1（SDF-1）是否为CI的特异性标志物，并根据合并慢性心血管疾病（CVD）的病史阐明了血清SDF-1水平与CI之间的关系。我们测量了84例患者的SDF-1水平和其他血清学标志物（对照组，n = 20；无慢性CVD的CI患者，n = 21；无CI的慢性CVD患者，n = 20；合并慢性CVD的CI患者，n = 23）。CI患者比无CI患者年龄更大。CI组中的女性比无CI组更多。入院时，合并慢性CVD的CI患者的SDF-1水平显著高于其他组（P <.001）。合并慢性CVD的CI患者入院时的SDF-1水平显著高于出院时（P <.001），但无慢性CVD的CI患者并非如此。SDF-1水平在症状、受累部位或住院时间方面无差异。对于合并慢性CVD的CI患者，SDF-1水平的截断值为0.5 pg/mL时，SDF-1 的敏感性和特异性分别为91.3%和95%。曲线下面积（AUC）值为0.95。在逻辑回归分析中，SDF-1水平升高至>0.5 pg/mL是合并慢性CVD的CI的显著指标[比值比（OR），114.914；95%置信区间，10.51至>999.999；P <.001]。SDF-1可能是诊断慢性CVD患者CI的有用早期生物标志物。
