Primary Study On Immunoglobulin G4 In Inflammatory Bowel Disease And Risk Factors In Active Phase

PartⅠ: Primary study on Immunoglobulin G4 expression in IBD patientsOBJECTIVE: To observe the expression of Ig G4 in serum and intestinal tissues of patients with inflammatory bowel disease,and to compare the expression of Ig G4 in the active phase of IBD disease,and to explore the clinical significance of Ig G4 expression changes in inflammatory bowel disease.METHODS: 1.68 patients with inflammatory bowel disease(including 40 Crohn’s disease,28 ulcerative colitis)and 20 normal controls.The serum Ig G4 level was determined by nephelometry,and Ig G4 in the intestinal tract was observed by immunohistochemistry.The difference in expression of Ig G4 between the two groups was compared.2.68 patients with IBD were divided into two groups according to the disease activity,and the changes of Ig G4 in intestinal tissues during active and inactive phases were compared.3.The level of serum CRP was determined by immunoturbidimetry,and the correlation between the expression of Ig G4 in intestinal tissue and serum CRP level in IBD patients was analyzed.RESULTS: 1.The expression of Ig G4 in intestinal tissue of IBD group was significantly higher than that of normal control group(P<0.05).There was no difference of serum Ig G4 level between two groups(P>0.05).2.The expression of Ig G4 in intestinal tissue of IBD patients was significantly higher than that of non-active group(P<0.01).There was a positive correlation between intestinal Ig G4 expression and serum CRP level in IBD patients(P<0.01).CONCLUSION: The expression of intestinal Ig G4 was significantly increased in IBD patients.Intestinal Ig G4 also enhanced in IBD active stage.The expression of intestinal Ig G4 in IBD patients was positively correlated with serum CRP level.Part Ⅱ: Logistic analysis of risk factors in IBD active phaseOBJECTIVE: To collect 19 related factors including clinical features,laboratory parameters and endoscopic findings in active and inactive groups of 68 patients with inflammatory bowel disease.To initially assess the risk factors of active IBD patients by univariate and multivariate logistic regression analysis.METHODS: Sixty-eight patients with inflammatory bowel disease were graded according to grading criteria.Crohn’s disease was scored by CDAI index.Ulcerative colitis was modified with Mayo score,CDAI index >150 or Mayo score>2 was defined as active period,according to the score.It is divided into active period group(n=39)and inactive period group(n=29).19 factors including clinical characteristics,test parameters and endoscopic findings were collected.Univariate and multivariate logistic regression analysis were used to initially assess the risk factors of active IBD patients.RESULTS: 1.Univariate analysis showed that there were significant differences in age,duration of disease,hemoglobin,ESR,CRP,and Ig G4 positive in intestinal tissue between the two groups(P<0.05).The OR values were 12.5,1.047,1.033,4,0.964 and 0.952 respectively.2.Multivariate regression analysis found that age of onset,hemoglobin,Ig G4 positive in intestinal tissue,and CRP were independent risk factors for IBD activity.CONCLUSION: Low onset age,low hemoglobin,Ig G4-positive in intestinal tissue,and elevated CRP are risk factors of active IBD patients.