血清生物标志物在溃疡性结肠炎诊治应用中的研究进展

The Latest Research Progress on the Application of Serum Biomarkers in the Diagnosis and Treatment of Ulcerative Colitis

摘要: 溃疡性结肠炎(ulcerative colitis, UC)是一种慢性、非特异性的肠道炎症性疾病，其诊断和疗效监测长期依赖内镜与组织病理学检查，这些“金标准”虽准确但具有侵入性、费用高昂且患者依从性差。因此，开发便捷、无创且能反映疾病活动度的血清生物标志物成为临床迫切需求。传统血清指标如C反应蛋白(CRP)和红细胞沉降率(ESR)虽临床应用广泛，但敏感性与特异性有限，部分活动期患者可表现为正常水平。近年来，随着对UC免疫病理机制的深入认识，包括肠上皮屏障功能障碍、固有免疫与适应性免疫的异常激活、以及肠道微生态紊乱，一系列新型血清生物标志物相继涌现，如肠道微生态标志物、肠道屏障损伤相关标志物、基因组学相关标志物。本文系统梳理该领域的研究进展，为实现UC的精准诊疗提供新的思路和手段。

Abstract: Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease whose diagnosis and therapeutic monitoring have long relied on endoscopic and histopathological examinations. Although these ‘gold standards’ are accurate, they are invasive, costly, and associated with poor patient compliance. Therefore, there is an urgent clinical need to develop convenient, non-invasive serum biomarkers that can reflect disease activity. Although traditional serum markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are widely used in clinical practice, their sensitivity and specificity are limited, and some patients with active disease may present with normal levels. In recent years, with a deeper understanding of the immunopathological mechanisms of UC—including intestinal epithelial barrier dysfunction, aberrant activation of innate and adaptive immunity, and gut microbiota dysbiosis—a range of novel serum biomarkers have emerged, such as gut microbiome-related markers, intestinal barrier injury-associated markers, and genomics-related markers. This article systematically reviews the research progress in this field, aiming to provide new ideas and approaches for achieving precision diagnosis and treatment of UC.