钙卫蛋白、白细胞介素-6 和 C 反应蛋白在鉴别炎症性肠病与腹泻型肠易激综合征中的作用。
Role of Calprotectin, IL-6, and CRP in Distinguishing Between Inflammatory Bowel Disease and Diarrhea Predominant Irritable Bowel Syndrome.
机构信息
Department of Biochemistry, Thai Nguyen University of Medicine and Pharmacy (TUMP), Thai Nguyen, Vietnam.
Department of Biochemistry, Thanh Nhan Hospital, Hanoi, Vietnam.
出版信息
Med Arch. 2024;78(2):105-111. doi: 10.5455/medarh.2024.78.105-111.
BACKGROUND
The early establishment of prophylaxis and immediate administration of anticoagulant therapy upon the diagnosis of venous thromboembolism should be the treatment objectives in these patients.
OBJECTIVE
The study aimed to determine the optimal cut-off point of Calprotectin, IL-6 (interleukin-6), CRP (C reactive protein) to differentiate UC, IBS-D.
METHODS
A cross-sectional descriptive study of 335 individuals ≥15 years old was performed, including 31 healthy controls, 215 with IBS-D, 71 diagnosed with UC, and 18 diagnosed with CD. Receiver Operating Characteristics (ROC), sensitivity, specificity, and area under curve (AUC) were computed.
RESULTS
The results showed that the median value of calprotectin (IQR) in healthy participants was 20.0 (6.0 - 34.0) µg/g; 17,7 (8,7-38,9) µg/g in IBS-D group; 1710.0 (588 - 4260,0) µg/g in UC group; and 560.5 (177.8 - 1210.0) µg/g in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of CRP (range IQR) was 1,3 (0,9 - 2,3) mg/L in IBS-D group; 7.0 (2.4 -16.6) mg/L in UC group; and 10.1 (2.2 - 42.5) mg/L in CD group. CRP concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of IL-6 (range IQR) was 2.3 (1.6 - 5.7) pg/mL in IBS-D group; 16.8 (9.4 - 47.0) pg/mL in UC group; and 9.4 (7.9 - 11.0) pg/mL in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The optimal cut-off point of calprotectin that differentiated IBS-D from IBD was 110.5 µg/g, with sensitivity and specificity of 93.3% and 91.4%, respectively; of IL-6 was 7.2 pg/mL with sensitivity and specificity of 92.0% and 78.0%, respectively; of CRP of 2.4 mg/L had specific sensitivities of 83.3% and 86.0%, respectively.
CONCLUSION
The Calprotectin immunoassay has the best value in discriminating between IBD and IBS-D.
背景
静脉血栓栓塞症患者的治疗目标应是早期进行预防，并在确诊后立即给予抗凝治疗。
目的
本研究旨在确定钙卫蛋白、白细胞介素 6（IL-6）和 C 反应蛋白（CRP）的最佳截断值，以区分溃疡性结肠炎（UC）和肠易激综合征腹泻型（IBS-D）。
方法
进行了一项横断面描述性研究，纳入了 335 名年龄≥15 岁的个体，包括 31 名健康对照者、215 名 IBS-D 患者、71 名 UC 患者和 18 名 CD 患者。计算了受试者工作特征（ROC）曲线、敏感性、特异性和曲线下面积（AUC）。
结果
结果显示，健康参与者的钙卫蛋白中位数（IQR）为 20.0（6.0-34.0）µg/g；IBS-D 组为 17.7（8.7-38.9）µg/g；UC 组为 1710.0（588-4260.0）µg/g；CD 组为 560.5（177.8-1210.0）µg/g。UC 和 CD 在内的 IBD 组的钙卫蛋白浓度高于 IBS-D 组，差异有统计学意义（P<0.05）。CRP 的中位数（范围 IQR）在 IBS-D 组为 1.3（0.9-2.3）mg/L；UC 组为 7.0（2.4-16.6）mg/L；CD 组为 10.1（2.2-42.5）mg/L。UC 和 CD 在内的 IBD 组的 CRP 浓度高于 IBS-D 组，差异有统计学意义（P<0.05）。IL-6 的中位数（范围 IQR）在 IBS-D 组为 2.3（1.6-5.7）pg/mL；UC 组为 16.8（9.4-47.0）pg/mL；CD 组为 9.4（7.9-11.0）pg/mL。UC 和 CD 在内的 IBD 组的 IL-6 浓度高于 IBS-D 组，差异有统计学意义（P<0.05）。区分 IBS-D 和 IBD 的最佳钙卫蛋白截断值为 110.5µg/g，敏感性和特异性分别为 93.3%和 91.4%；IL-6 为 7.2pg/mL，敏感性和特异性分别为 92.0%和 78.0%；CRP 为 2.4mg/L，特异性敏感性分别为 83.3%和 86.0%。
结论
钙卫蛋白免疫测定在区分 IBD 和 IBS-D 方面具有最佳价值。
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