| Objective:Inflammatory bowel disease(IBD)is a set of possible and the environment,heredity,infection,immunity and other factors related to chronic nonspecific intestinal inflammatory disease,at present in our country the incidence of inflammatory bowel disease rate was significantly higher than before,there are characteristics of alternating episodes of exacerbation and remission.At present mainly depends on the clinical symptoms and signs,laboratory examination,endoscopy,pathology and imaging etc to judge the disease activity,repeated colonoscopy pain and difficult to check in the short term,and so a noninvasive index is easy to check and assess the relative specificity of the disease activity more important.At present,a variety of fecal inflammatory markers play an important role in the diagnosis,activity evaluation,relapse,efficacy evaluation and postoperative management of inflammatory bowel disease.The purpose of this experiment is to detect fecal inflammatory markers such as fecal calprotectin and neutrophil gelatinase related lipid transporters as a non-invasive method for intestinal diseases,and assist in the evaluation of disease activity.Methods: According to the strict inclusion criteria and exclusion criteria,69 cases were selected,including 54 cases of ulcerative colitis and Crohn’s disease diagnosed by colonoscopy and pathology,and 15 healthy controls.Before colonoscopy,the patients were asked to keep the feces for about 5g and cryopreservation at-80 degrees.The concentrations of fecal calprotectin and neutrophil gelatinase related lipid carriers were detected by ELISA,and the clinical symptoms,endoscopic findings,C reactive protein and erythrocyte sedimentation rate were collected.In the first study the disease activity,alleviate the concentration of fecal period and healthy control group in the corresponding index,correlation and evaluation of fecal inflammation index and clinical score and endoscopic score,and evaluate the correlation between ESR and CRP,and finally studied the sensitivity and specificity of the evaluation of disease activity index.Result:UC FC levels in patients with active stage and remission stage and the normal control group were 305.43pg/ml,254.49pg/ml and 222.74pg/ml activity was significantly higher than that in remission stage and the normal control group,remission is higher than the normal control group;FC CD patients in remission stage and the normal control group the concentration of 331.94pg/ml,225.41pg/ml and 222.74pg/ml respectively.Activity concentration was significantly higher than that of the normal control group,remission and normal control group had no significant difference.UC patients with fecal NGAL concentration of active and remission stage and the normal control group,respectively 8.36ug/l,7.05ug/l and 5.95ug/l,there was statistical significance in active and remission stage concentration difference,remission was statistically significant compared with control group study;patients with active CD,remission stage and control group NGAL concentration were 8.86ug/l,7.40ug/l and 5.95ug/l,active and remission stage difference was statistically significant,remission and normal control group also has statistical significance,although the activity period and remission period no obvious concentration gradient of NGAL,but low concentration of NGAL is helpful in identifying the low level of inflammatory disease.There was a certain correlation between FC concentration and clinical and endoscopic scores in UC patients(r= 0.598P=0.000,r= 0.519 P=0.001);FC in CD patients was correlated with clinical score(r=0.716 P=0.001),but not correlated with endoscopic score.There was no significant correlation between the stool NGAL concentration of UC and CD patients with the clinical and endoscopic score(r=0.278 P=0.105 r=0.314 P=0.066;r=0.248 P=0.305r=0.357 P=0.133).In UC and CD patients,the correlation between FC and NGAL was not significant(r=0.153 P=0.380 r=0.307 P=0.201),which was different from the previous experimental results.In UC and CD in patients with FC and CRP and ESR in the evaluation of disease activity has no significant correlation(r=0.277,P=0.108;r=0.315,P=0.074,UC and CD)in patients with NGAL CRP and ESR in the evaluation of disease activity correlation was not significant(r=0.094,P=0.592,r=0.085,P=0.638).In the judgment of disease in patients with UC activity of the FC joint detection sensitivity,specificity and two sensitivity and specificity for the detection of(81.80%,87.50%,55.60%,87.50%,40.74%,100%);judging activities of FC disease in patients with CD the sensitivity,specificity and two sensitivity and specificity of combined detection for the detection of(91.70%,85.70%,83.30%,71.40%,75%,85.70%),FC in determining the sensitivity and specificity of IBD is better than that of fecal NGAL activity of the two combined detection could improve the sensitivity and reduce the specificity of detection.Conclusion:1,FC concentration and NGAL concentration detection helps to judge the disease activity of IBD patients;2,the concentration of FC and IBD in patients with positive clinical and endoscopic score,in clinic can be combined with clinical and endoscopic score to judge the disease activity in IBD patients;3,FC in the sensitivity and specificity of UC and CD is better than that of fecal NGAL judgment of disease activity;combined FC and NGAL two index can reduce the sensitivity of the judgment of disease activity two,enhancing its specificity. |
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