克罗恩病患者血清淀粉样蛋白A与内镜评分的相关性分析

Correlation of serum amyloid A level with endoscopic score in patients with Crohn’s disease

关键词:  血清淀粉样蛋白A  克罗恩病  简化内镜评分  黏膜愈合

Key words:  serum amyloid A  Crohn’s disease  simplified endoscopic score  mucosal healing

摘要:

目的探讨血清淀粉样蛋白A(serum amyloid A, SAA)与克罗恩病(Crohn’s disease, CD)患者内镜评分的相关性。方法选取同济大学附属第十人民医院2021年1月—2022年2月收治的103例CD患者，检测所有患者SAA、C反应蛋白(C-reactive protein, CRP)、红细胞沉降率(erythrocyte sedimentation rate, ESR)、白介素-6(interleukin-6, IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)及白介素-1β(interleukin-1β, IL-1β)浓度，所有患者均进行结肠镜检查并行CD简化内镜评分(simple endoscopic score in CD, SES-CD)，探讨各炎症指标与SES-CD的相关性。结果SAA、CRP、ESR、IL-6、TNF-α浓度与SES-CD评分均呈正相关，相关系数(rs)分别为0.585、0.552、0.400、0.297、0.208，均P<0.05，IL-1β浓度与SES-CD无相关性；SAA、CRP、ESR预测SES-CD的曲线下面积值(AUC)分别为0.809、0.766、0.721，均P<0.001。结论与其他炎症指标相比，SAA能够更好地预测CD患者黏膜愈合情况，尤其适用于经济能力有限或内镜检查依从性差的反复复发的CD患者疾病活动性的评估，值得临床推广应用。

Abstract:

ObjectiveTo investigate the correlation of serum amyloid A(SAA) level with endoscopic score in patients with Crohn’s disease. MethodsA total of 103 CD patients admitted to Shanghai Tenth People’s Hospital from January 2021 to February 2022 were recruited. The serum levels of SAA, C-reactive protein(CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and erythrocyte sedimentation rate(ESR) were measured. All patients underwent colonoscopy and evaluated with CD simplified endoscopic score(SES-CD), the correlation of serum indicators with SES-CD was analyzed. ResultsThe serum levels of SAA, CRP, IL-6, TNF-α and ESR were positively correlated with SES-CD scores, the Spearman’s rank correlation coefficients(rs) were 0.585, 0.552, 0.297, 0.208, 0.400, respectively(all P<0.05); while of IL-1β level was not correlated with SES-CD. The area under the ROC curve(AUC) of SAA, CRP and ESR in predicting SES-CD were 0.809, 0.766 and 0.721, respectively(all P<0.001). ConclusionCompared with other inflammatory indicators, SAA can better predict disease activity for CD patients, which is worthy of clinical promotion.