Clinical Significance Of Blood Routine Indicators In Judging Inflammatory Bowel Disease Activity In Children

Objective:This study was to investigate the clinical significance of blood routine indicators for the activity judgment of inflammatory bowel disease in children.Methods:The observation group was selected from January 2014 to January 2019 in the Department of Pediatric Digestive Surgery,the First Hospital of Jilin University,and was diagnosed as IBD(Crohn's disease or ulcerative colitis).Refer to the 2010 Chinese Medical Association Pediatrics Branch Digestive Group Children's Inflammation Consensus opinion on the diagnosis of enteropathy [9],based on clinical,laboratory examination,endoscopy,imaging examination and pathological examination to obtain a diagnosis,the clinical data is complete,the diagnosis is clear,the age,sex,and disease of the child are collected.The age of onset and diagnosis,family history and surgical history,and the treatment of immunosuppressive agents,biological agents,etc.,were followed up for 4-5 years.Another 31 children from the first physical examination of Jilin University were selected as the control group.Comparison of peripheral blood albumin(Hb),white blood cell count(WBC),platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),and platelet count(PCT)in the control and observation groups.Relationships and comparisons with erythrocyte sedimentation rate(ESR),PCT,high-sensitivity C-reactive protein,endoscopy in assessing the sensitivity of disease activity.For the measurement data,the mean ± standard deviation is used for statistical description.For the comparison between the two groups obeying the normal distribution,the t test is used,and for the two groups that do not obey the normal distribution,the nonparametric test(rank sum test)is used;The data were statistically described by the number of cases and percentage or frequency,and the chi-square test was used for comparison between groups.Spearman correlation analysis was used to explore the correlation between blood routine indicators and hs-CRP,ESR and disease status.The ROC curve was used to evaluate the diagnostic value of blood routine markers as biomarkers in the diagnosis of inflammatory bowel disease,and the area under the ROC curve(AUC)was calculated to calculate the sensitivity and specificity of each index.P<0.05 was used as the criterion for statistically significant difference.Statistical method:Result:In children with active IBD,PLT and PCT levels were higher,and MPV and Hb levels were lower than those in healthy and remission.PLT and PCT were significantly associated with hs-CRP and ESR(P < 0.001),and HB was negatively correlated with disease activity(P < 0.05).The receiver operating characteristic curve(ROC curve)showed that the PLT count was the best indicator for distinguishing children with active IBD(AUC 0.843,sensitivity 76.67%,specificity 80.65% P < 0.001),PCT as a marker,AUC only Second to hs-CRP.Conclusion:Our study showed that children with IBD had higher PLT counts,higher PCT and white blood cell levels,lower MPV and Hb levels,and a negative correlation between Hb and IBD severity.Even in the active phase of IBD,there are children with normal hs-CRP,and PLT count and PCT are positively correlated with hs-CRP and ESR.PLT count can be used as a specific and sensitive biomarker for the active period of children with IBD.Sensitivity is superior to hs-CRP;although PCT is associated with PLT counts and MPV,it can also be used as an alternate biomarker for determining IBD specificity and sensitivity during active phase.