摘要
目的探讨改良Mayo内镜评分(IMES)对溃疡性结肠炎的评估价值。方法回顾性分析2015年1月~2021年11月在北京清华长庚医院诊断为溃疡性结肠炎患者临床及内镜资料,共纳入167位患者。内镜病变严重程度采用Mayo内镜评分法(MES,0~3分),及溃疡性结肠炎镜下严重程度指数(UCEIS,0~8分)进行评分,内镜下病变范围采用Montreal分型。将MES评分同Montreal分型结合得出改良Mayo内镜评分。结果IMSE与改良Truelove和Witts疾病严重程度分型、Mayo评分(MS)以及部分Mayo评分(pMS)相关性(r=0.712、0.784、0.703),优于单独MES(r=0.642、0.754、0.604)、Montreal分型(r=0.598、0.628、0.603)以及UCEIS(r=0.670、0.767、0.677)。ROC曲线显示IMES对诊断重度、中-重度UC的临界值为4.5、3.5,曲线下面积(AUC)优于单独的MES、Montreal以及UCEIS。IMES与各项临床化验指标均有相关性,r值为C反应蛋白(0.583),白细胞(0.235),血红蛋白(-0.280),血小板(0.352),血清白蛋白(-0.396),红细胞沉降率(0.471),相关系性均优于单独的MES或Montreal分型。ROC曲线显示IMES=5分较MES=3分、E3、UCEIS≥6分预测患者近期接受全身激素、免疫抑制剂或手术的价值更高。结论IMES能更好地反映UC临床严重程度,与临床化验指标具有良好的相关性。
Objective To assess the value of Improved Mayo Endoscopic Score(IMES)for evaluation of the clinical severity of ulcerative colitis(UC).Methods We retrospectively analyzed the clinical and endoscopic data of 167 patients diagnosed with UC in Beijing Tsinghua Changgung Hospital from January,2015 to November,2021.The severity of endoscopic lesions was determined by Mayo Endoscopic Score(MES,0-3 points)and the Ulcerative Colitis Endoscopic Index of Severity(UCEIS)score(0-8 points),and the scope of endoscopic lesions was evaluated based on the Montreal classification system.The IMES was established by combining the MES with the Montreal classification.Results The IMSE showed stronger correlations with modified Truelove and Witts Disease Severity,Mayo score and partial Mayo score(r=0.712,0.784,and 0.703,respectively)than MES(r=0.642,0.754,and 0.604,respectively),Montreal classification(r=0.598,0.628,and 0.603,respectively)and UCEIS(r=0.670,0.767,and 0.677,respectively).ROC curve analysis showed that IMES was superior to MES,Montreal and UCEIS in diagnosis of severe and moderate-to-severe UC.IMES also showed stronger correlations with the laboratory indicators including CRP(r=0.583),WBC(r=0.235),HB(r=-0.280),PLT(r=0.352),ALB(r=-0.396)and ESR(r=0.471)than MES and Montreal classification.An IMES score of 5 was of greater value than a MES score of 3,E3,and UCEIS≥6 for predicting the administration of systemic hormones,immunosuppressants,or surgery in the near future.Conclusion IMES can better reflect the clinical severity of UC and has good correlations with the laboratory indicators of the patients.
作者
宋泽军
张明君
任渝棠
姜泊
SONG Zejun;ZHANG Mingjun;REN Yutang;JIANG Bo(Department of Gastroenterology,Beijing Tsinghua Changgung Hospital,Beijing 102218,China)
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2022年第7期997-1005,共9页
Journal of Southern Medical University
