| Objective Patients with ulcerative colitis,whose exsited intestinal inflammation activity,because of the intestinal mucosal barrier damage,have a hallmark that many inflammatory makers fall into the intestinal lumen with feces,detecting the levers of fecal inflammatory markers contributes to the assessment of intestinal inflammation activity degree,can be used as an important supplement method to colonoscopy.To discuss and detecting the lever of intestinal alkaline phosphatase(IAP),calprotectin(Cal), matrix metalloproteinase-9(MMP- 9), myeloperoxidase(MPO),neopterin(Npt) in ulcerative colitis( UC) patients’ feces and the clinical significancein.Methods The 50 hospitalized patients clinically diagnosed with UC from June 2013 to May 2014,from Department of Gestroenterology of the first Affiliated Hospital,Anhui Medical University were collected,including 33 male cases, 17 female cases,They were15 to 73 years old and the average age was 40.42±14.81;The course of the disease varied from 1 month to 30 years and the median duration was 2.00 years; 15 cases were incipient,33 cases were chronic recurrent,2 case was chronic type Among them;15 cases had proctitis, 6 cases had left-sided colitis and 29 cases had pancolitis. Meanwhile choose 50 cases of normal people with no symptoms of gastrointestinal tract within one month as the normal control group, including 30 males and 20 females,whose age varied from 16 to 65 and the average age was 38.27±14.21.The disease activity, type of UC for these 50 patients were determined according to IBD diagnostic and therapeutic criteria from Chinese Society of Gastroenterology(Guangzhou, 2012). The clinicalseverity classification was determined by the UC Troulove and Witts standards.The disease activity was determined by DAI scores from the Mayo grading standard.Collect fresh stool specimens of 50 copies of normal persons and 50 copies of UC patients before and after treatment.Detect IAP levels by the methods of p-nitrophenyl phosphate(p-NPP),determine fecal Cal, MMP-9 and Npt levels using enzyme-linked immunosorbent assay(ELISA), determine level of fecal MPO Using spectrophotometry.Compare the level of fecal IAP, Cal, MMP- 9, MPO,Npt of UC patients with that of normal control group,analyze the relevance between these five kinds of fecal markers and clinical featurein in patients with UC and monitor changes before and after the treatment.Results1)UC patients clinical cases choice: There were more men than women in 50 patients with UC,The sex was ratio 1.9:1,The average age was 40.42±14.81 years old,Median duration was 2.00 years.Among them,21 cases were mild,23 cases were moderate and 3cases were severe.The cases of mild and moderate severity were the most common(93.6%). In all cases, 66% were chronic relapsing,30% were first onset, and 2 case was continuous type.The most of the patients revealed pancolitis(58%),12% of patients had left-sided colitis,30% of patients had Most of the proctitis revealed mild and moderate severity.2)Detection of IAP、Cal、MMP-9、MPO、Npt in feces of UC patients:the lever of IAP in UC’ feces was lower than normal control group(t=3.96,P<0.01).Differences of fecal IAP levels in UC patients with different Clinical severity and different lesion range were not statistically significant. the lever change of IAP in UC’feces before and after treatment showed significant difference(t=6.84,P<0.01).Fecal Cal levels in active UC patients(179.19±39.86 μg/g)were significantly higher than that in patients with remission( 146.6±6.69 μg/g) and normal control group( 14.00±3.11 μg/g). UC Cal level comparisons between three active stages(mild,moderate, severe) were statistically significant(P< 0.01). Fecal Cal levels in UC patients significantly correlated with MDAI(r=0.81,P<0.01). Fecal Cal levels in UC patients decreased after treatment(142.30±40.30 μg/g) than before treatment(177.23±39.43μg/g),Changed with significant difference(t=4.80,P<0.01).Fecal MMP-9 levels in active UC patients( 21.03±7.89 ng/ml) was significantly higher than that in patients with remission( 13.56±2.70 ng/ml)and normal control group(3.07±1.47 ng/ml). UC MMP-9 level comparisons between three active stages(mild, moderate, severe) were statistically significant(P< 0.01). Fecal MMP-9 levels in UC patients significantly correlated with MDAI(r=0.48,P<0.01). Fecal MMP-9 levels in UC patients decreased after treatment(16.14±6.06 ng/ml) than before treatment( 20.58±7.87 ng/ml) in patients feces, Changed with significant difference(t=3.13,P<0.01).Fecal MPO levels in active UC patients(1.03±0.28 U/ml)were significantly higher than that in patients with remission( 0.53±0.34 U/ml) and Normal control group(0.08±0.04 U/ml). UC MPO level comparisons between three active stages(mild,moderate, severe) were statistically significant(P<0.05). Fecal MPO levels in UC patients significantly correlated with MDAI(r=0.32,P<0.05). Fecal MPO levels in UC patients decreased after treatment( 0.10±0.03 U/ml) than before treatment( 1.00±0.30 U/ml) in patients feces,Changed with significant difference(t=23.05,P<0.01).Fecal Npt levels in UC patients(0.47±0.18 ng/ml)were significantly higher than that in patients with remission(0.37±0.17 ng/ml) and normal control group(0.17±0.04ng/ml). UC Npt level comparisons between three active stages(mild, moderate, severe)were statistically significant(P<0.05). Fecal Npt levels in UC patients significantly correlated with DAI( r=0.31,P<0.05). Fecal Npt levels in UC patients decreased after treatment( 0.41±0.17 ng/ml) than before treatment( 0.46±0.18 ng/ml) inpatients stool,Changed with significant difference( t=3.60,P<0.01).3)Correlated analysis of the levels of Cal, MMP-9, MPO, Npt in UC patients’ feces showed that Cal and MMP-9 levels had some correlation(r=0.43,P<0.01) while Other specifications had no obvious correlation(P>0.05).4) Correlation between fecal Cal, MMP-9, MPO, Npt levels and other serological markers in UC patients: Four fecal markers had no significant correlation with the two clinical laboratorial evaluation indicators.Conclusion The levels of fecal IAP in patients with UC decreased,The levels of fecal Cal, MMP-9, MPO, Npt increased significantly,The levels of fecal IAP increased after treatment,The levels of fecal Cal, MMP-9, MPO, Npt reduced significantly,Detection of these fecal markers contribute to evaluate intestinal inflammation and judge curative effect in patients with UC. |
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