Діагностична цінність клініко-лабораторних параметрів у діагностиці неспецифічного виразкового коліту

Abstract

The etiology of ulcerative colitis is still unknown. The number of works dealing with a comprehensive assessment of the role of clinical, laboratory, endoscopic, as well as immunological and genetic factors in the formation of unfavorable forms of ulcerative colitis is extremely small, and their results seem ambiguous. The purpose of the study was to determine the diagnostic value of clinical and laboratory signs in relation to verification of the depth of endoscopic lesion in patients with ulcerative colitis. Material and methods. 68 patients with ulcerative colitis (36 men and 32 women) were examined. The average age was 38.0±4.5 years. All patients were inspected with colonoscopy. Clinical, laboratory, immunological research, as well as computed tomography were carried out. Disease activity was determined according to the Truelove-Witts classification. Results and discussion. The obtained results showed that all intestinal symptoms (stool frequency more than 4 times a day, abdominal pain, tenesmus, hematochezia) had a reliable diagnostic value (р<0.05) in the presence of contact vulnerability and ulceration of the intestinal mucosa. The greatest sensitivity was characteristic of abdominal pain (94.1 [84.1-96.3]). It was found that the diagnostic sensitivity of tachycardia and uveitis is unreliable. Among the clinical indicators, the greatest diagnostic value was established for anemic syndrome (p<0.05), among additional signs was for sclerosing cholangitis (p<0.05). With regard to laboratory parameters, the diagnostic value was proven for hemoglobin levels <90 g/l (p<0.05) and hypoproteinemia (p<0.05). The diagnostic concentration of C-reactive protein for predicting a mucosal defect was determined at a level of more than 10 mg/L in terms of sensitivity and specificity (p<0.05). The level of fecal calprotectin more than 200 μg/g (p<0.05) was highly sensitive and highly specific. Conclusion. The study showed the possibilities of computed tomography for verifying of ulcerative defects. The method is highly sensitive in ulcerative colitis (sensitivity is 95.6 [85.9-97.1], specificity is (96.7 [83.3-99.4]), with a low probability of false-negative and false-positive results (p<0.05)