摘要
目的:探讨结肠镜联合C-反应蛋白(CRP)水平对溃疡性结肠炎(UC)患者疾病活动度的评估价值.方法:将我院2020年12月至2022年12月收治的66例溃疡性结肠炎患者作为研究参与者,对所有患者进行结肠镜检查,根据改良Mayo评分系统分为轻度20例、中度28例、重度18例,观察分析不同严重程度UC患者CRP、内镜下肠壁厚度参数,采用单因素及多因素Logistic回归分析发生重度UC的相关影响因素,建立ROC曲线分析结肠镜联合CRP水平对UC患者疾病活动度的评估价值.结果:重度UC患者CRP水平均较轻度UC、中度UC高,且中度UC较轻度UC高(P＜0.05);重度UC患者固有肌层厚度、黏膜下层厚度、黏膜层厚度、肠壁总厚度均较轻度UC、中度UC厚,且中度UC较轻度UC厚(P＜0.05);单因素分析显示,轻中度UC患者与重度UC患者在性别、病程时间、发作次数方面比较无显著性差异(P＞0.05),在CRP、固有肌层厚度、黏膜下层厚度、黏膜层厚度、肠壁总厚度方面比较有显著性差异(P＜0.05);多因素Logistic回归分析显示,CRP、固有肌层厚度、黏膜下层厚度、黏膜层厚度、肠壁总厚度是重度UC发生的独立影响因素(P＜0.05);ROC曲线分析显示,CRP、固有肌层厚度、黏膜下层厚度、黏膜层厚度、肠壁总厚度联合诊断重度UC患者的灵敏度、特异度、AUC分别为85.3％、92.6％、0.856,均高于单项指标(P＜0.05).结论:CRP、固有肌层厚度、黏膜下层厚度、黏膜层厚度、肠壁总厚度是重度UC发生的独立影响因素,且结肠镜内镜下肠壁厚度参数联合CRP水平检测对UC患者疾病活动度具有较好的预测价值.
Abstract
Objective To investigate the evaluation value of colonoscopy combined with C-reactive pro-tein(CRP)level in patients with ulcerative colitis(UC).Methods Total 66 patients with ulcerative co-litis admitted to our hospital from December 2020 to December 2022 were included as study participants.All patients underwent colonoscopy,and were divided into mild(20 cases),moderate(28 cases)and severe(18 cases)according to the modified Mayo scoring system.CRP level and endoscopic intestinal wall thick-ness parameters of UC patients with different severity were observed and analyzed.Univariate and multiva-riate Logistic regression analysis were used to analyze the related influencing factors of severe UC.ROC curve was established to analyze the evaluation value of colonoscopy combined with CRP level in patients with UC.Results The CRP level of severe UC patients was higher than that of mild and moderate UC patients,which was higher in the moderate UC patients than in the mild UC patients(P＜0.05).The thickness of propria muscular layer,submucosal layer,mucosal layer and total intestinal wall in the severe UC patients were thicker than those in the mild and moderate UC patients,which were thicker in the mod-erate UC patients than in the mild UC patients(P＜0.05).Univariate analysis showed that there was no significant difference in gender,course of disease,and number of attacks between mild and moderate UC patients and severe UC patients(P＞0.05),but there were significant differences in CRP level and thick-ness of propria muscular layer,submucosal layer,mucosal layer and total intestinal wall(P＜0.05).Mult-ivariate Logistic regression analysis showed that CRP level and thickness of propria muscular layer,submu-cosal layer,mucosal layer and total intestinal wall were independent influencing factors for severe UC(P＜0.05).ROC curve analysis showed that the sensitivity,specificity,and AUC of CRP level and thickness of propria muscular layer,submucosal layer,mucosal layer and total intestinal wall in the diagnosis of se-vere UC patients were 85.3％,92.6％,and 0.856,respectively,which were higher than those of single indi-cator(P＜0.05).Conclusion CRP level and thickness of propria muscular layer,submucosal layer,mucosal layer and total intestinal wall are independent influencing factors for severe UC,and the parame-ters of intestinal wall thickness under colonoscopy combined with CRP level detection have good predictive value for disease activity in UC patients.
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