缺血性结肠炎患者结肠镜下表现及缺血修饰白蛋白的诊断价值分析

Analysis of colonoscopic manifestations and diagnostic value of ischemia-modified albumin in patients with ischemic colitis

摘要:

目的 探究缺血性结肠炎（IC）患者结肠镜下表现及血清缺血修饰白蛋白（IMA）的诊断价值。方法 选取2018年1月－2021年3月该院收治的IC患者267例（IC组），另选取同期因便血接受治疗的200例患者作为对照组。所有观察者行结肠镜检查，并用酶联免疫吸附试验检测IMA水平，将结肠病变组织行HE染色后观察病理形态。结果 对照组存在糖尿病病史与脑梗死的患者分别占总人数的5.00%与2.00%，IC组存在糖尿病病史与脑梗死的患者分别占总人数的11.99%与9.74%，两组患者比较，差异均无统计学意义（P > 0.05）；对照组患者住院时间为（3.54±1.86）d，存在腹部手术史、高血压、冠心病和心房颤动的患者分别占总人数的13.00%、17.00%、4.00%和2.00%，IC组患者住院时间为（9.13±4.28）d，存在腹部手术史、高血压、冠心病和心房颤动的患者分别占总人数的29.96%、43.45%、15.73%和10.11%，两组患者比较，差异均有统计学意义（P < 0.05）。对照组IMA水平为（0.13±0.02）mg/mL，明显低于IC组的（12.48±1.25）mg/mL，差异有统计学意义（P < 0.05）。受试者操作特征曲线（ROC）的曲线下面积为0.85，敏感度为87.26%，特异度为75.31%，准确率为83.41%，阳性预测值为89.26%，阴性预测值为71.33%，Kappa值为0.71。结论 IMA在IC患者中呈现高表达，利用IMA诊断IC，无创、简便，灵敏度与特异度较高，其是临床诊断IC的一种安全、有效的新方法。

Abstract:

Objective To explore the colonoscopic manifestations and diagnostic value of ischemia-modified albumin (IMA) in patients with ischemic colitis (IC).Methods 267 patients with IC from January 2018 to March 2021 were selected. Another 200 patients who received treatment for hematochezia during the same period were selected as the control group. Colonoscopy was performed on IC patients, IMA level was detected by enzyme-linked immunosorbent assay, and pathological morphology was observed by HE staining.Results Patients with diabetes history and cerebral infarction accounted for 5.00% and 2.00% of the total number of patients in the control group, and patients with diabetes history and cerebral infarction accounted for 11.99% and 9.74% of the total number of patients in the IC group, there was no statistical significance between the two groups (P > 0.05). In the control group, the hospital stay was (3.54 ± 1.86) d. Patients with history of abdominal operation, hypertension, coronary heart disease and atrial fibrillation accounted for 13.00%, 17.00%, 4.00% and 2.00% of the total number, respectively. In the IC group, the hospital stay was (9.13 ± 4.28) d. Patients with history of abdominal operation, hypertension, coronary heart disease and atrial fibrillation accounted for 29.96%, 43.45%, 15.73% and 10.11% of the total number of patients, respectively, and the difference between the two groups was statistically significant (P < 0.05). The IMA level in control group was (0.13 ± 0.02) mg/mL, which was significantly lower than that in IC group (12.48 ± 1.25) mg/mL, and the difference was statistically significant (P < 0.05). The area under ROC curve was 0.85, the sensitivity was 87.26%, the specificity was 75.31%, the accuracy rate was 83.41%, the positive predictive value was 89.26%, the negative predictive value was 71.33% and the Kappa value was 0.71.Conclusion IMA is significantly overexpressed in patients with IC. IMA has the characteristics of non-invasive, simple, high sensitivity and specificity for the diagnosis of IC, which provides a new method for clinical diagnosis of ischemic colitis.