| Objective:Inflammatory bowel disease(IBD)with unknown etiology,which includes ulcerative colitis(UC)and crohn’s disease(CD).current methods to assess the activity of IBD includeinflammatory markers such as ESR,CRP and endoscopic check.ESR CRP is deficient in sensitivity and specificity.colonoscopy is an invasive detection method,and the patient compliance is low,which is not conducive to long-term monitoring.the number of macrophages in the intestinal tissues of IBD patients increased significantly,in the intestinal macrophages marker,CD163 is a special marker for macrophage activation,which is released into the cycle is sCD163,it can be discharged form the urine,So this study aims to explore the role of urine sCD163 levels in clinical diagnosis and treatment of the IBD patients.Methods : Gastroenterology of the first affiliated hospital of Anhui medical university A total of 146 patients with clinically diagnosed IBD were enrolled from October 2015 to December 2016.Among them,UC 60 cases,CD 86 cases,80 males and 66 females,the average age was(30.3±7.5)years.The IBD diagnostic criteria refer to "China’s Diagnosis and Management of inflammatory bowel disease consensus opinion of the Chinese Medical Association of Digestive Diseases Inflammatory Bowel Disease Group(2012 ·Guangzhou).healthy control group included standard: recent routine physical examination is normal,without chronic disease,tumor,family generic disease,autoimmune disease history.no alimentary tract disease and drug history in recent 2months.they average age was(15-63 years).The urine samples on the first day of admission were collected.the collected of urine specimens were added with preservative,then 5 ml of the mixture was placed at-20℃.The levels of sCD163 in urine and plasma samples in IBD group and healthy control group were detected byenzyme-linked immunosorbent assay(ELISA),and the clinical features were analyzed.Results:(1)The general information of IBD patients and healthy control group There were 146 cases of IBD patients,including 60 cases of UC patients and 86 cases of CD patients.The UC patients,48 cases in actively,and 12 cases in remission.23 cases were mild,20 cases were moderate and 5 cases were severe.Among them,there were15 cases of E1 type,29 cases of E2 type and 16 cases of E3 type.The CD patients,22 cases in actively,and 64 cases in remission.48 cases were moderate,16 cases were severe.23 cases of L1 type,25 cases of L2 type and 38 cases of L3 type;There were 56 cases of B1 type,20 cases of B2 type,10 cases of B3 type;the healthy control group,were ranged from 16 to 63 years old.(2)The detection of sCD163 levels in urinary IBD patients and healthy controls Urine sCD163 levels of IBD all higher than the healthy control group.which reach the difference(P<0.05).the levels of urine sCD163 were significantly higher in CD patients than in the control group((0.33 ± 0.08)μg/ml)vs(0.06 ± 0.03)μg/ml)P<0.01),the levels of urine sCD163 were significantly higher in UC patients than in the control group((0.35 ± 0.11)μg/ml vs(0.06 ± 0.03)μg /ml)P<0.01).(3)Association analysis of sCD163 levels and clinical features in urine of IBD patients.The urine levels of sCD163 in remission of UC group were 0.36±0.15μg/ml,which were lower than those in active period.the levels of urine sCD163 in mild of UC patients were 0.24±0.08μg/ml,Moderate activity 0.38 ±0.09μg/ml,severe group0.54±0.05ug/ml,were significantly higher than those in healthy control groups.severe group were not statistically significant.he levels of urine sCD163 in group E1,E2 and E3 were not reach the difference(p> 0.05).The urine levels of sCD163 in remission of CD group were 0.28±0.13ug/ml,which were lower than those in active period.the levels of urine sCD163 in mild of CD patients were 0.33±0.08μg/ml,Moderate activity 0.32±0.12μg/ml,severe group0.34±0.06μg/ml,were significantly higher than those in healthy control groups.Severe group were not statistically significant.The levels of urine sCD163 in group L1,L2 and L3 were not reaching the difference(p> 0.05).B1,B2 and B3 were reach the difference(p<0.05).(4)The analysis of sCD163 levels between in urine in IBD patients and CRP,ESR and Mayo/ CDAI score.In UC,there was no significant difference in sCD163 urine levels between CRP,ESR and Mayo In CD,there was no significant difference in sCD163 urine levels between ESR,but significant difference with CRP and CDAI score.(5)Detection and comparison of urine sCD163 in IBD patients before and after treatment Before the treatment,the levels of urine sCD163 in UC group were 0.35±0.11μg/ml and after0.13±0.07μg/ml,and in CD group were 0.25±0.13μg/ml and 0.16±0.81μg/ml.The difference between before and after treatment both in UC and CD group were significantly different(p<0.05).Conclusion:1.The levels of urine sCD163 in IBD patients were higher than those in the healthy control groups,and the difference was statistically significant.2.The levels of urine sCD163 in UC were significantly higher in both the remission and the active period than in the healthy control group,but there was no significant difference between the group,analyze the UC lesion range,the E1,E2,E3 patients,urine sCD163 were higher than those in the healthy control,but there was no significant difference between the group.3.The levels of urine sCD163 in CD were significantly higher in both the remission and the active period than in the healthy control group,but there was no significant difference between the group,analyze the CD site,the L1,L2,L3 patients,urine sCD163 were higher than those in the healthy control,but there was no significant difference between the group,analyze the CD disease behavior,the B1,B2,B3 patients,urine sCD163 were higher than those in the healthy control,the difference was statistically significant,and the comparison between the groups was statistically significant.4.The levels of urine sCD163 in UC patients were no significantly correlated with ESR,CRP and Mayo scoring.The levels of urine sCD163 in CD patients were significantly correlated with CRP and CDAI scoring,5.Urine sCD163 levels were decreased after the treatment of the IBD,the difference was statistically significant. |
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