儿童慢性肠病的诊断方法

T. Yaroshevska, K. Skriabina
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摘要

根据临床评估、实验室数据、放射学、内窥镜和组织学征象,诊断儿童炎症性肠病并将其与功能性疾病区分开来是很复杂的。因此,在儿科,大量的注意力已经给予标准的侵入性评估方法。最近,研究人员致力于将粪便钙保护蛋白作为一种敏感的非侵入性粪便检测方法。本研究旨在探讨粪便钙保护蛋白对儿童慢性炎症性肠病的诊断价值。本文探讨粪便钙护蛋白在35例3 ~ 17岁儿童溃疡性结肠炎、非特异性非溃疡性结肠炎和肠易激综合征中的诊断和监测作用。单克隆抗体ELISA法检测粪钙保护蛋白浓度。结果。研究表明,在非特异性溃疡性和非溃疡性结肠炎患者中,粪便钙保护蛋白水平超过正常范围2-5倍,与疾病的临床和形态学表现以及炎症标志物水平相对应。然而,这一生物标志物在肠易激综合征儿童中并不超过平均值。结论。粪便钙保护蛋白试验使我们能够区分器质性和功能性肠道疾病,监测慢性炎症性肠病的活动动态,并评估治疗效果。在初级医疗保健框架内应用粪便钙保护蛋白试验可以减少炎性肠病患者进行侵入性内窥镜、实验室和放射检查的转诊次数
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Diagnostic approach to chronic bowel diseases in children
Diagnosing inflammatory bowel diseases in children and differentiating them from functional disorders is complicated based on clinical assessment, laboratory data, and radiological, endoscopic, and histological signs. Therefore, in paediatrics, substantial attention has been given to standard invasive evaluation methods. Recently, research efforts have been directed towards using faecal calprotectin as a sensitive non-invasive stool test. The aim of the research was to study the diagnostic value of faecal calprotectin in pediatric chronic inflammatory bowel diseases. The paper discusses faecal calprotectin's diagnostic and monitoring role in 35 children aged 3 to 17 years with ulcerative colitis, non-specific non-ulcerative colitis, and irritable bowel syndrome. The concentration of the faecal calprotectin level was examined by ELISA using monoclonal antibodies. Results. The study shows that in patients with non-specific ulcerative and non-ulcerative colitis, the faecal calprotectin level exceeds the normal ranges 2-5 times, corresponding to clinical and morphological manifestations of the diseases and the level of inflammatory markers. However, this biological marker does not exceed the average values in children with irritable bowel syndrome. Conclusions. The faecal calprotectin test allows us to differentiate organic and functional intestinal diseases, monitor chronic inflammatory bowel disease activity dynamics, and estimate treatment effectiveness. Applying the faecal calprotectin test within the framework of primary medical care can decrease the number of referrals for invasive endoscopic, laboratory, and radiologic examinations in pediatric patients with inflammatory bowel diseases
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