碱性磷酸酶组化染色在炎症性肠病鉴别诊断中的价值

摘要

Objective To evaluate the value of alkaline phosphatase histochemical staining in the differential diagnosis of inflammatory bowel disease. Methods The expression of alkaline phosphatase BCIP/NBT in intestinal mucosa was detected by alkaline phosphatase BCIP/NBT histochemical staining in 34 Crohn's disease(group CD) ,36 ulcerative colitis(group UC) and 15 noninflammatory bowel disease (group NIBD, including 12 intestinal tuberculosis, 2 bacterial intestinal infection and 1 ischemic colitis). Results The BCIP/NBT alkaline phosphatase positive staining [BCIP/NBT( + )] rate was higher in group CD than that in groups of UC and NIBD(85. 29% vs. 5. 56%和0)(P<0. 05). The sensitivity,specificity,positive prediction rate and negative prediction rate of BCIP/NBT histochemical staining were 93. 55%,90. 74%,85. 29% and 96. 08%,respectively. There was no any significant correlation between BCIP/NBT(+) and the location, perianal lesions, activity level and pathological category of CD(P>0. 05). Conclusion BCIP/NBT alkaline phosphatase histochemical staining can be taken as an useful assistant index in the diagnosis and differential diagnosis of CD.%目的 探讨碱性磷酸酶组化染色在炎症性肠病鉴别诊断中的价值.方法 应用BCIP／NBT组化染色检测34例克罗恩病(CD组)、36例溃疡性结肠炎(UC组)及15例非炎症性肠病(NIBD组,包括12例肠结核、2例细菌性肠道感染和1例缺血性结肠炎)肠黏膜中肠碱性磷酸酶表达水平.结果 CD组碱性磷酸酶组化染色阳性率显著高于UC组和NIBD组(85.29％vs.5.56％和0)(P＜0.05).碱性磷酸酶组化染色诊断CD的敏感性为93.55％,特异性为90.74％,阳性预测率为85.29％,阴性预测率为96.08％；其与CD病变部位、是否伴有肛周病变、活动度及病变类型无明显相关性(P＞0.05).结论 碱性磷酸酶BCIP/NBT组化染色可以作为CD诊断的一个辅助指标.