Papi C, Ciaco A, Bianchi M, Montanti S, Koch M, Capurso L
Department of Digestive Diseases and Nutrition, Azienda Complesso Ospedaliero S. Filippo Neri, Rome, Italy.
J Clin Gastroenterol. 1996 Jul;23(1):40-3. doi: 10.1097/00004836-199607000-00011.
Several activity indexes, including clinical variables, laboratory variables or both, have been proposed to assess the activity and severity of Crohn's disease (CD). Although activity indexes are commonly used in clinical trials, doubts exist as to whether it is correct to group together and quantify under the same numerical expression the very heterogeneous clinical manifestations of CD. The aim of our study was to try to establish a correlation between clinical and laboratory activity indexes of CD in subgroups of patients with primarily inflammatory or primarily fibrostenosing clinical characteristics. At least two activity indexes were calculated among 232 outpatient examinations in 61 CD patients. Indexes were classified as clinical, laboratory, or both. A close correlation was observed when indexes calculated on clinical variables were compared or when those that include only or prevalently laboratory parameters were compared. Conversely, the correlation between clinical and laboratory indexes tended to be poor. Taking into consideration the subgroups of patients, the correlation between clinical and laboratory indexes was high in primarily inflammatory disease but low in the primarily fibrostenosing form. The clinical activity of CD does not always reflect the quantity of inflammation measured by laboratory parameters. This is particularly true in primarily fibrostenosing disease. Different clinical patterns of CD should always be considered in the attempt to quantify with an activity index the activity and severity of disease.
已经提出了几种活动指数，包括临床变量、实验室变量或两者兼有，以评估克罗恩病（CD）的活动度和严重程度。尽管活动指数在临床试验中常用，但对于将CD非常异质性的临床表现归为一组并用同一数值表达式进行量化是否正确仍存在疑问。我们研究的目的是试图在主要具有炎症性或主要具有纤维狭窄性临床特征的患者亚组中建立CD临床和实验室活动指数之间的相关性。在61例CD患者的232次门诊检查中计算了至少两种活动指数。指数分为临床指数、实验室指数或两者兼有。比较基于临床变量计算的指数时，或比较仅包含或主要包含实验室参数的指数时，观察到密切的相关性。相反，临床指数和实验室指数之间的相关性往往较差。考虑患者亚组时，临床指数和实验室指数之间的相关性在主要为炎症性疾病中较高，但在主要为纤维狭窄性疾病中较低。CD的临床活动度并不总是反映实验室参数所测量的炎症程度。在主要为纤维狭窄性疾病中尤其如此。在试图用活动指数量化疾病的活动度和严重程度时，应始终考虑CD的不同临床模式。
