Li Tong, Qian Yuting, Bai Tingting, Li Juanjuan
Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China.
Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ann Transl Med. 2022 Feb;10(4):185. doi: 10.21037/atm-22-123.
Patients with inflammatory bowel disease (IBD) can develop a series of complications over time, including fistulas and perforation, strictures and pseudopolyp formation. Whether there are some effective and economical routine inspection indicators for the early prediction and prevention of complications has clinical significance and is worth exploring.
A total of 592 newly diagnosed IBD patients [153 with ulcerative colitis (UC), 439 with Crohn's disease (CD)] were enrolled in a retrospective study. We compared the baseline characteristics (age at diagnosis, sex, clinical disease location and stage), serum C-reactive protein (CRP) level, serum erythrocyte sedimentation rate (ESR) level, total white blood cell (WBC), eosinophil (EOS) and platelet (PLT) counts for all IBD patients. And we evaluated the correlation between these routine parameters and the occurrence of clinical complications (including fistula, perforation, stricture, pseudopolyps or cancerous changes) in the course of IBD by univariate and multivariate analyses. Moreover, we constructed a dual parameter prediction system for complication's verification.
We demonstrated that higher serum CRP levels and total WBC counts independently indicated a higher hazard for the earlier occurrence of pseudopolyp formation in UC patients. Likewise, higher serum ESR and lower eosinophil count predicted the development of fistulas in CD patients, and higher serum ESR and PLT counts accounted for CD patients' strictures.
Novel predictive models including CRP level, ESR, WBC count, PLT and eosinophils were structured to predict complications in IBD, which might enable more aggressive treatment for patients at risk.
炎症性肠病（IBD）患者随着时间推移会出现一系列并发症，包括瘘管和穿孔、狭窄以及假息肉形成。是否存在一些有效且经济的常规检查指标用于早期预测和预防并发症具有临床意义，值得探索。
一项回顾性研究纳入了592例新诊断的IBD患者[153例溃疡性结肠炎（UC）患者，439例克罗恩病（CD）患者]。我们比较了所有IBD患者的基线特征（诊断时年龄、性别、临床疾病部位和分期）、血清C反应蛋白（CRP）水平、血清红细胞沉降率（ESR）水平、白细胞（WBC）总数、嗜酸性粒细胞（EOS）和血小板（PLT）计数。通过单因素和多因素分析，我们评估了这些常规参数与IBD病程中临床并发症（包括瘘管、穿孔、狭窄、假息肉或癌变）发生之间的相关性。此外，我们构建了一个双参数预测系统来验证并发症。
我们证明，较高的血清CRP水平和白细胞总数独立表明UC患者较早出现假息肉形成的风险较高。同样，较高的血清ESR水平和较低的嗜酸性粒细胞计数预测了CD患者瘘管的发生，较高的血清ESR水平和PLT计数是CD患者出现狭窄的原因。
构建了包括CRP水平、ESR、白细胞计数、PLT和嗜酸性粒细胞在内的新型预测模型来预测IBD中的并发症，这可能使对有风险的患者进行更积极的治疗成为可能。
