PTX3在评估溃疡性结肠炎患者疾病活动度中的作用

The Role of PTX3 in Assessing Disease Activity in Ulcerative Colitis

摘要: 目的：本研究旨在探究PTX3作为评估UC疾病活动度生物标志物的临床价值。方法：选取134例UC患者和40例健康对照，收集其血标本，及8例UC患者和4例健康对照的结肠黏膜，测定血清PTX3水平，检测结肠黏膜巨噬细胞CD86表达量，分析血清PTX3水平与UC患者疾病活动度、炎性指标的关系及与结肠黏膜巨噬细胞CD86表达量的相关性。结果：UC患者血清PTX3水平明显高于健康对照组。随着病情加重，患者血清PTX3水平逐渐升高。重度UC患者血清PTX3水平显著高于中度，中度显著高于轻度。UC患者血清PTX3水平与ESR等炎症指标呈正相关，与ALB和HGB呈负相关。ROC曲线分析显示，PTX3区分UC患者与健康对照的AUC是0.977。PTX3、FC、ESR区分UC轻度、中度活动以及中度、重度活动UC患者的AUC分别是0.825、0.927、0.842和0.700、0.720、0.671，三者联合预测UC轻度、中度活动以及中度和重度活动的AUC分别是0.986、0.805。活动期UC患者结肠黏膜巨噬细胞CD86表达较健康对照明显上调，与UC患者血清PTX3水平呈正相关。结论：UC患者血清PTX3水平在不同疾病活动期中有明显差异，与患者ESR等炎性指标显著相关，对评估UC患者病情活动度有一定的辅助价值。

Abstract: Objective: This study aims to investigate the clinical value of PTX3 as a biomarker for evaluating disease activity in ulcerative colitis (UC). Methods: A total of 134 UC patients and 40 healthy controls were included. Blood samples were collected from all participants, and colon mucosal biopsies were taken from 8 UC patients and 4 healthy controls. Serum PTX3 levels were measured, and CD86 expression in colonic macrophages was assessed. Clinical data of UC patients were also collected. The differences in serum PTX3 levels across various disease activities of UC, along with the correlation between PTX3 levels, inflammatory markers, and macrophage CD86 expression, were analyzed. Results: Serum PTX3 levels were significantly higher in UC patients compared to healthy controls. As disease severity increased, serum PTX3 levels gradually elevated. Severe UC patients had significantly higher PTX3 levels than those with moderate UC, and moderate UC patients had higher levels than those with mild UC. Serum PTX3 levels were positively correlated with inflammatory markers such as ESR, and negatively correlated with ALB and HGB. ROC curve analysis showed an AUC of 0.977 for PTX3 in distinguishing UC patients from healthy controls. The AUCs for PTX3, FC, and ESR in differentiating mild, moderate, and severe UC activity were 0.825, 0.927, 0.842, and 0.700, 0.720, 0.671, respectively. The combined use of PTX3, FC, and ESR to predict mild, moderate, and severe UC activity had AUCs of 0.986 and 0.805, respectively. During the active phase of UC, CD86 expression in colonic macrophages was significantly higher in UC patients than in healthy controls, and it positively correlated with serum PTX3 levels. Conclusion: Serum PTX3 levels in UC patients vary significantly across different disease activity stages and are strongly correlated with inflammatory markers like ESR. PTX3 may be a valuable adjunctive biomarker for assessing UC disease activity.