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目的探讨同型半胱氨酸(Hcy)、D-二聚体(D-D)在溃疡性结肠炎(UC)中的早期诊断价值。方法检测64例UC患者(UC组)、38例普通肠炎患者(疾病对照组)、32名健康体检者(健康对照组)血清Hcy、D-D水平,利用ROC曲线分析血清Hcy、D-D在早期诊断UC中的作用。结果 UC组患者血清Hcy、D-D水平均明显高于疾病对照组和健康对照组(P<0.05);UC组患者中,活动期UC患者血清D-D水平明显高于缓解期患者(P<0.05),且重度患者血清D-D水平明显高于中度和轻度患者(P<0.05),血清Hcy水平在活动期和缓解期,以及不同严重程度的UC患者中,差异无统计学意义(P>0.05)。相关性分析显示,UC患者血清D-D水平与疾病活动指数(DAI)、血沉(ESR)、C反应蛋白(CPR)均呈明显正相关(P<0.05),而血清Hcy水平与DAI、ESR、CPR均无明显相关性(P>0.05)。D-D检测诊断UC的ROC曲线下面积、约登指数均明显高于Hcy、CRP,差异有统计学意义(P<0.05)。结论 UC患者血清D-D水平可作为判断炎症严重程度的重要指标,其在UC早期的诊断价值高于Hcy和CRP。
Objective To investigate the early diagnostic value of homocysteine (Hcy) and D-dimer (D-D) in ulcerative colitis (UC). Methods Serum Hcy and DD levels were measured in 64 patients with UC (UC group), 38 patients with common enteritis (disease control group) and 32 healthy controls (healthy control group). Serum Hcy and DD were analyzed by ROC curve in the early diagnosis of UC In the role. Results The serum levels of Hcy and DD in patients with UC were significantly higher than those in controls and healthy controls (P <0.05). In patients with UC, the serum levels of DD in patients with active UC were significantly higher than those in patients with remission (P <0.05) Serum DD level was significantly higher in severe patients than in moderate and mild patients (P <0.05). There was no significant difference in serum Hcy levels between active and remission stages and UC patients of different severity (P> 0.05) . Correlation analysis showed that serum DD levels in patients with UC were positively correlated with disease activity index (DAI), ESR and C-reactive protein (CPR) (P <0.05), while serum Hcy level was positively correlated with DAI, ESR, No significant correlation (P> 0.05). The area under the curve of ROC curve and the Youden index of D-D test were significantly higher than those of Hcy and CRP (P <0.05). Conclusions Serum D-D level in UC patients can be used as an important index to judge the severity of inflammation. The diagnostic value of UC in early stage of UC is higher than that of Hcy and CRP.