Dr Md Fazlul Karim Chowdhury, Assistant Professor, Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2024 Oct;33(4):1149-1156.
Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory disorder of the gastrointestinal tract with relapsing and remitting course. Recurrent abdominal pain and discomfort in association with abnormal defecation in the absence of structural abnormality of the gut is the key feature of irritable bowel syndrome (IBS). Faecal biomarker may be used a precise tool in the differentiation of IBD and IBS. The aim of this study was to measure faecal calprotectin (FC) in patients with IBD and IBS and compare between them. This was a cross-sectional study done in the department of Gastroenterology, BSMMU, Bangladesh from May 2017 to August 2018. IBD patients were diagnosed on the basis of compatible history, clinical examination, laboratory, radiological and endoscopic findings. IBS patients were selected by using the Rome IV criteria. Quantitative faecal calprotectin ELISA (BUHLMANN Quantum Blue) test was done and compared between IBD and IBS patients. In this study, ninety (90) patients were enrolled, 45 patients with IBD and 45 patients with IBS. Mean age of the IBD patients was 32.24±9.76 years and IBS patients was 33.80±9.70 years. There were 28(62.2%) male and 17(37.8%) female patients with IBD and 30(66.7%) male and 15(33.3%) female patients with IBS. We found faecal calprotectin (FC) level was 445.68±237.35μg/gm in IBD patients and 39.16±17.31μg/gm in IBS patients. There was a significant difference of faecal calprotectin level between IBD and IBS patients (p-value <0.001). The sensitivity and specificity of faecal calprotectin to differentiate IBD from IBS was 91.1% and 86.7% respectively. The test accuracy was 88.9%. Area under ROC was 0.959 (95% CI, 0.909 to 1.0). This study showed that faecal calprotectin appears to be clinically useful, non-invasive, rapid and reliable marker to differentiate IBD from IBS.
炎症性肠病（IBD）是一种慢性特发性胃肠道炎症性疾病，具有反复发作和缓解的特点。反复发作的腹痛和不适伴有排便异常而无肠道结构异常是肠易激综合征（IBS）的主要特征。粪便生物标志物可作为区分 IBD 和 IBS 的精确工具。本研究旨在测量 IBD 和 IBS 患者的粪便钙卫蛋白（FC）并比较两者之间的差异。这是一项在孟加拉国 BSMMU 胃肠病科进行的横断面研究，时间为 2017 年 5 月至 2018 年 8 月。IBD 患者根据临床表现、实验室检查、影像学和内镜检查结果进行诊断。IBS 患者采用罗马 IV 标准选择。进行定量粪便钙卫蛋白 ELISA（BUHLMANN Quantum Blue）检测，并比较 IBD 和 IBS 患者之间的差异。本研究共纳入 90 例患者，其中 45 例为 IBD 患者，45 例为 IBS 患者。IBD 患者的平均年龄为 32.24±9.76 岁，IBS 患者为 33.80±9.70 岁。IBD 患者中有 28 例（62.2%）为男性，17 例（37.8%）为女性；IBS 患者中有 30 例（66.7%）为男性，15 例（33.3%）为女性。我们发现 IBD 患者的粪便钙卫蛋白（FC）水平为 445.68±237.35μg/gm，IBS 患者为 39.16±17.31μg/gm。IBD 和 IBS 患者的粪便钙卫蛋白水平差异有统计学意义（p 值<0.001）。粪便钙卫蛋白区分 IBD 和 IBS 的敏感性和特异性分别为 91.1%和 86.7%，检测准确性为 88.9%。ROC 曲线下面积为 0.959（95%CI，0.909 至 1.0）。本研究表明，粪便钙卫蛋白似乎是一种有用的、非侵入性的、快速的、可靠的标志物，可用于区分 IBD 和 IBS。
