ПРОГНОЗИРОВАНИЕ РИСКА НАЛИЧИЯ ВОСПАЛИТЕЛЬНЫХ ЗАБОЛЕВАНИЙ КИШЕЧНИКА У ПАЦИЕНТОВ БЕЗ ЛАБОРАТОРНЫХ ПРИЗНАКОВ ВОСПАЛЕНИЯ

Abstract

AbstractSome patients with inflammatory bowel disease (IBD) may not have traditional criteria of inflammation: elevated CRP, ESR and leukocytosis. The aim of this study was to identify additional immunological and biochemical criteria for the risk of IBG in patients with no non-specific laboratory criteria of inflammation. The study involved 150 patients, of whom 2 groups were formed: an observation group (100 patients with a verified diagnosis of ulcerative colitis or Crohn's disease) and a control group (50 clinically healthy individuals). All subjects underwent a complete blood count, a biochemical blood test and determination of IL-1β, TNF-α, and IL-4 concentrations. Based on the results of general and biochemical blood tests, patients from the observation group were divided into two subgroups - with and without classic laboratory signs of inflammation. Three main laboratory blood parameters were assessed for diagnosing the inflammatory process: ESR, white blood cell count and CRP level. The presence of laboratory signs of inflammation was considered to be an increase in two or more of the above blood parameters. It was noted that 40% of patients with IBD had no non-specific laboratory criteria of inflammation: in ulcerative colitis in 37% of cases, in Crohn's disease in 46% of cases (p < 0.001). Further, a comparative analysis of the levels of cytokines and biochemical markers in the blood serum of patients from the control group and patients with IBD without laboratory signs of inflammation was carried out. Based on the obtained data, a prognostic model of the probability of the presence of IBD in patients with no non-specific laboratory criteria for inflammation, depending on biochemical and immunological blood parameters was developed. The model included such serum parameters as glucose, sodium and IL-4 concentrations. The predictive ability of the model was assessed using ROC analysis (AUC 0.970±0.018 95% CI: 0.936–1.000; p<0.001). An algorithm for predicting the risk of IBD in patients without non-specific laboratory criteria of inflammation was proposed. The obtained data made it possible to identify additional criteria for the risk of IBD in patients with the absence of non-specific metabolic criteria of inflammation.

Keywords

• inflammatory bowel disease
• ulcerative colitis
• crohn's disease
• laboratory criteria of inflammation
• c-reactive protein
• erythrocyte sedimentation rate
• white blood cell count
• il-4
• glucose
• sodium.