摘要目的 探讨胶囊内镜评分指数(Lewis评分)与简化克罗恩病活动指数(CDAI)、血清C反应蛋白(CRP)评估小肠克罗恩病病变活动程度的相关性.方法 58例胶囊内镜检查的小肠克罗恩病患者行Lewis评分和简化CDAI评分,同时检测血清CRP水平,Lewis评分与简化CDAI、血清CRP的相关性行Spearman's秩相关检验,血清CRP判断胶囊内镜下疾病活动程度的特性采用工作特征曲线(ROC曲线)进行分析.结果 Lewis评分结果显示非活动期患者13例、轻度黏膜炎症患者21例、中-重度黏膜炎症患者24例,中-重度黏膜炎症患者组血清CRP平均值明显高于非活动期患者组和轻度黏膜炎症患者组(P＜0.05),ROC曲线分析结果显示区分胶囊内镜下中-重度黏膜炎症患者与轻度黏膜炎症和非活动期患者的血清CRP截值为13.50 mg/L,曲线下面积为0.849,敏感度为87.5％,特异度为82.4％.Lewis评分与简化CDAI、血清CRP的相关性检验结果显示胶囊内镜Lewis评分与血清CRP呈中度相关(r=0.58,P＜0.01),与简化CDAI呈弱相关(r=0.40,P＜0.01).结论 简化CDAI和血清CRP不能完全替代Lewis评分用于评估小肠克罗恩病患者胶囊内镜下病变的炎症程度,但血清CRP对判断胶囊内镜下中-重度黏膜炎症有一定指导价值.

abstractsObjective To investigate the correlation between any two of Capsule Endoscopy ScroringIndex (Lewis score),simplified Crohn Disease Activity Index (CDAI) and C-reactive protein (CRP) in small bowel Crohn disease (CD).Methods A total of 58 consecutive patients with known small bowel CD were enrolled. We evaluated disease activity with Lewis score and simplified CDAI. Correlations among CRP,simplified CDAI and Lewis score were calculated with Spearman's rank order correlation coefficient.The optimal CRP cut-off value was calculated using the ROC curve.Results The Lewis score showed inactive,mild and moderate-severe patients were 13,21 and 24,respectively.CRP of moderate-severe group was significantly higher than that in mild and inactive groups ( P ＜ 0.05 ).The optimal CRP cut-off value that differentiated patients with moderate to severe disease from the others was 13.50 mg/L with sensitivity of 87.5％ and specificity of 82.4％.The area under the ROC curve to analyze the cut-off was 0.849.Lewis score was moderately correlated with CRP (r =0.58,P ＜ 0.01 ),and weakly correlated with the simplified CDAI (r =0.40,P ＜ 0.01 ).Conclusion Serum CRP and the simplified CDAI cannot replace Lewis score for capsule endoscopy in the assessment of disease activity in small bowel CD.However,CRP may be considered as an inflammatory marker for evaluating the moderate to severe capsule endoscopic activity.