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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2023, Vol. 17 ›› Issue (12) : 1304 -1308. doi: 10.3877/cma.j.issn.1674-0785.2023.12.015

临床研究

血清胰蛋白酶2在克罗恩病炎症程度评估中的价值
王卫峰, 刘维薇†()   
  1. 200032　上海，上海中医药大学附属龙华医院检验科;200070　上海，同济大学附属第十人民医院中心实验室&检验科
  • 收稿日期:2023-10-19 出版日期:2023-12-15
  • 通信作者: 刘维薇
  • 基金资助:
    上海市卫计委优秀学科带头人培养计划(2018BR07)

Clinical value of serum serine protease 2 in evaluation of severity of inflammation in Crohn's disease

Weifeng Wang, Weiwei Liu†()   

  1. Clinical Laboratory of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;Central Clinical Laboratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200070, China
  • Received:2023-10-19 Published:2023-12-15
  • Corresponding author: Weiwei Liu
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王卫峰, 刘维薇. 血清胰蛋白酶2在克罗恩病炎症程度评估中的价值[J]. 中华临床医师杂志(电子版), 2023, 17(12): 1304-1308.

Weifeng Wang, Weiwei Liu. Clinical value of serum serine protease 2 in evaluation of severity of inflammation in Crohn's disease[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(12): 1304-1308.

目的

探讨血清胰蛋白酶2（PRSS2）指标在评估克罗恩病（CD）炎症程度中的作用。

方法

回顾性纳入2018年8月至2022年6月上海市第十人民医院收治的51例CD患者、16例结直肠癌患者及28名健康对照。收集所有受试者临床资料，酶联免疫吸附法（ELISA）法检测所有受试者血清中PRSS2水平，分析其与临床病理特征的关系，并用二元logistic回归分析PRSS2对CD炎症程度的诊断价值。

结果

缓解期到中度和重度活动期CD患者中血清PRSS2水平呈现上升趋势，重度活动期患者中显著高于中度活动期及缓解期患者（P<0.05）。相关性分析显示，CD患者中PRSS2与CRP具有显著相关性（r=0.7013，P=0.0001），PRSS2与CDAI具有显著相关性（r=0.4703，P=0.0009）。受试者工作特征（ROC）曲线分析显示，PRSS2水平区分中度活动期与重度活动期CD的ROC曲线下面积（AUC）为0.7756（95%CI：0.6085~0.9428，P=0.0062），区分缓解期与重度活动期CD的ROC曲线AUC为0.8643（95%CI：0.7418~0.9868，P=0.0002）。

结论

血清PRSS2水平在CD炎症程度评估中具有一定的临床价值。

关键词: 克罗恩病, 胰蛋白酶2, 炎症程度
Objective

To assess the value of serum serine protease 2 (PRSS2) in assessing the extent and severity of inflammation in Crohn's disease (CD).

Methods

This study included 51 CD patients and 16 patients with colorectal cancer admitted to Shanghai Tenth People's Hospital between August 2018 and June 2022, as well as 28 healthy subjects. The clinical data from all subjects were collected, and the serum level of PRSS2 was measured by enzyme-linked immunosorbent assay (ELISA). The relationship between PRSS2 levels and clinical pathological features was examined. The diagnostic value of PRSS2 in determining the severity of CD inflammation was assessed by binary logistic regression analysis.

Results

Serum PRSS2 levels increased with the deterioration of CD from remission stage to active stage. The PRSS2 level was significantly higher in severe active CD than in CD in the remission stage and moderate active stage (P<0.05). Correlation analysis showed that there was a significant correlation between PRSS2 and C-reactive protein (r=0.7013, P=0.0001) and Crohn's disease activity index (r=0.4703, P=0.0009). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of the PRSS2 level in distinguishing moderately active versus severely active CD was 0.7756 (95% confidence interval [CI]: 0.6085-0.9428, P=0.0062), and it was 0.8643 (95%CI: 0.7418-0.9868, P=0.0002) in distinguishing CD in remission versus severely active CD.

Conclusion

The findings of this study suggest that serum PRSS2 has diagnostic value for the severity of CD inflammation.

Key words: Crohn's disease, Serine protease 2, Severity of inflammation
表1 各组克罗恩病(CD)患者基本临床特征
项目 缓解期 中度 重度 χ2/t/H值 P值
例数（男/女） 21（15/6） 20（12/8） 10（4/6） 2.816 0.245
年龄（岁,） 31.57±12.93 32.15±9.03 36.70±11.73 0.752 0.477
患病年限[M(Q1,Q3)] 4.0（0,9.0） 5.5（3.0,7.0） 6.0（0,12.5） 0.526 0.769
复发史(例,是/否) 14/7 17/3 7/3 1.946 0.378
CRP[mg/L,M(Q1,Q3)] 3.02（3.02,3.88） 14.00（3.02,36.50）a 34.10（22.38,88.78）ab 20.473 0.000
CEA[μg/L,M(Q1,Q3)] 1.12（0.80,2.16） 0.96（0.57,1.44） 1.16（0.73,12.76） 1.489 0.475
PRSS2[μg/L,M(Q1,Q3)] 29.2（25.9,43.7） 48.3（39.2,56.2）a 79.52（43.83,101.49）ab 15.902 <0.001
图1 各组受试者血清PRSS2、CEA和CRP水平检测 A：PRSS2在不同组别中的水平；B：CEA在不同组别中的浓度；C：在不同组别血清CRP水平。 注：CD1为缓解期CD；CD2为中度活动期CD；CD3为重度活动期CD；CRC为结直肠癌；NC为对照组；PRSS2为胰蛋白酶2；CEA为癌胚抗原；CRP为C反应蛋白；aP<0.05;bP<0.01
图2 血清胰蛋白酶2（PRSS2）区分各期克罗恩病（CD）的受试者工作特征（ROC）曲线分析 A：PRSS2区分缓解期和中度活动期CD的ROC曲线分析；B：PRSS2区分缓解期和中度活动期CD的ROC曲线分析；C：PRSS2区分缓解期和中度活动期CD的ROC曲线分析
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