摘要
目的 探讨溃疡性结肠炎(ulcerative colitis,UC)患者血清Elabela,富亮氨酸α-2 糖蛋白-1(leucine-rich-alpha-2-glycoprotein-1,LRG1)表达及与疾病活动指数(disease activity index,DAI)的相关性.方法 选择2022年1月～2022年 12 月运城市中心医院收治的 98 例UC患者为UC组,其中活动期 62 例,缓解期 36 例.根据患者病情严重程度分为轻度组(n=26)、中度组(n=43)和重度组(n=29).根据内镜活动指数(endoscopic activity index,EAI)分为Ⅰ级组(n=25)、Ⅱ级组(n=40)和Ⅲ级组(n=33).根据内镜下黏膜愈合情况分为愈合组(n=65)和未愈合组(n=33).另取 51 例结肠息肉患者为对照组 1,50 例健康体检者为对照组 2.采用酶联免疫吸附法检测血清Elabela和LRG1 水平.Pearson法分析UC患者血清Elabela,LRG1 水平与疾病活动指数的相关性.受试者工作特征(ROC)曲线分析血清Elabela和LRG1 对内镜下黏膜愈合的预测价值.结果 UC组血清Elabela(4.77±1.36 ng/ml),LRG1(352.12±39.45 ng/ml)水平高于对照组 1(2.51±0.53 ng/ml,121.02±21.06 ng/ml)和对照组 2(2.35±0.42 ng/ml,120.35±23.49 ng/ml),差异具有统计学意义(t=11.410～39.000,均P＜0.05).活动期组血清Elabela(5.26±0.54 ng/ml),LRG1(370.42±12.49 ng/ml)高于缓解期组(3.93±0.42 ng/ml,320.60±8.47 ng/ml),差异具有统计学意义(t=12.705,21.242,均P＜0.05).重度组血清Elabela(5.89±0.20 ng/ml),LRG1(369.92±16.59 ng/ml)高于中度组(4.51±0.67 ng/ml,356.12±18.75 ng/ml)和轻度组(3.95±0.21 ng/ml,325.65±10.14 ng/ml),差异具有统计学意义(t=3.205～35.077,均P＜0.05).Ⅲ级组血清Elabela(5.80±0.18 ng/ml),LRG1(369.16±13.47 ng/ml)高于Ⅱ级组(4.49±0.35 ng/ml,355.46±16.34 ng/ml)和Ⅰ级组(3.86±0.16 ng/ml,324.15±8.71 ng/ml),差异具有统计学意义(t=3.854～48.725,均P＜0.05).未愈合组血清Elabela(5.12±0.42 ng/ml),LRG1(367.12±14.27 ng/ml)高于愈合组(4.08±0.37 ng/ml,322.57±10.35 ng/ml),差异具有统计学意义(t=12.043,15.917,均P＜0.05).UC患者血清Elabela,LRG1水平与EAI,红细胞沉降率呈正相关(r=0.602,0.298;0.576,0.302,均P＜0.05),与血红蛋白水平呈负相关(r=-0.351,-0.334,均P＜0.05).血清Elabela,LRG1 联合预测内镜下黏膜愈合的曲线下面积为0.926(95%CI:0.880～0.958),高于Elabela,LRG1单独预测的0.803(95%CI:0.741～0.856),0.783(95%CI:0.720～0.838),差异有统计学意义(Z=4.101,4.228,均P＜0.05).结论 UC患者血清Elabela,LRG1 水平升高,且与疾病活动指数增加和病情加重有关,检测血清Elabela,LRG1 可为UC内镜下黏膜愈合评估提供参考.
Abstract
Objective To investigate the expression of serum Elabela and leucine-rich-alpha-2-glycoprotein-1(LRG1)in ulcerative colitis(UC)patients and their correlation with disease activity index(DAI).Methods A total of 98 patients with UC admitted to Yuncheng Central Hospital from January to December 2022 were selected as the UC group,including 62 patients in active stage and 36 patients in remission stage.According to the severity of the disease,these patients were divided into mild group(n=26),moderate group(n=43)and severe group(n=29).In addition,these patients were grouped into gradeⅠ group(n=25),grade Ⅱ group(n=40)and grade Ⅲ group(n=33)based on the endoscopic activity index(EAI).According to the mucosal healing condition under endoscopy,these patients were divided into the healed group(n=65)and the unhealed group(n=33).Another 51 patients with colonic polyps were selected as control group 1,and 50 healthy individuals were selected as control group 2.Serum Elabela and LRG1 levels were detected by enzyme-linked immunosorbent assay(ELISA).Pearson method was used to analyze the correlation between serum Elabela,LRG1 levels and DAI in UC patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum Elabela and LRG1 for endoscopic mucosal healing.Results The levels of Elabela(4.77±1.36 ng/ml)and LRG1(352.12±39.45 ng/ml)in UC group were higher than those in control group 1(2.51±0.53 ng/ml,121.02±21.06 ng/ml)and control group 2(2.35±0.42 ng/ml,120.35±23.49 ng/ml),and the differences were statistically significant(t= 11.410～39.000,all P＜0.05).The levels of Elabela(5.26±0.54 ng/ml)and LRG1(370.42±12.49 ng/ml)in the active group were higher than those in the remission group(3.93±0.42 ng/ml,320.60±8.47 ng/ml),and the differences were statistically significant(t=12.705,21.242,all P＜0.05).The levels of Elabela(5.89±0.20 ng/ml)and LRG1(369.92±16.59 ng/ml)in the severe group were higher than those in the moderate groups(4.51±0.67 ng/ml,356.12±18.75 ng/ml)and mild groups(3.95±0.21 ng/ml,325.65±10.14 ng/ml),and the differences were statistically significant(t=3.205～35.077,all P＜0.05).The levels of Elabela(5.80±0.18 ng/ml)and LRG1(369.16±13.47 ng/ml)in grade Ⅲ group were higher than those in grade Ⅱ group(4.49±0.35 ng/ml,355.46±16.34 ng/ml)and grade Ⅰgroup(3.86±0.16 ng/ml,324.15±8.71 ng/ml),and the differences were statistically significant(t= 3.854～48.725,all P＜0.05).The levels of Elabela(5.12±0.42 ng/ml)and LRG1(367.12±14.27 ng/ml)in unhealed group were higher than those in healed group(4.08±0.37 ng/ml,322.57±10.35 ng/ml),and the differences were statistically significant(t=12.043,15.917,all P＜0.05).The serum levels of Elabela and LRG1 in UC patients were positively correlated with EAI and ESR(r=0.602,0.298;0.576,0.302,all P＜0.05),but negatively correlated with hemoglobin level(r=-0.351,-0.334,all P＜0.05).The area under the curve predicted by the combination of serum Elabela and LRG1 for endoscopic mucosal healing was 0.926(95%CI:0.880～0.958),was higher than the 0.803(95%CI:0.741～0.856)and 0.783(95%CI:0.720～0.838)predicted by Elabela and LRG1 alone,and the difference was statistically significant(Z=4.101,4.228,all P＜0.05).Conclusion The serum levels of Elabela and LRG1 in UC patients increased,and they were related to the increase of DAI and worsening of the condition.Testing serum Elabela and LRG1 can provide a reference for evaluating mucosal healing under UC endoscopy.
国家科技期刊平台
NSTL
维普
万方数据