medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2026-12-44-48medalphabet-5127Research ArticleСтатьиОценка возможности использования фекального кальпротектина для диагностики воспалительных заболеваний кишечника у пациентов с анкилозирующим спондилитомEvaluation of the possibility of using fecal calprotectin for the diagnosis of inflammatory bowel diseases in patients with ankylosing spondylitishttps://orcid.org/0000-0003-3747-9644КулаковаП. И.KulakovaP. I.

Кулакова Полина Игоревна, врач-ревматолог отделения ревматологии

Kulakova Polina I., rheumatologist at Dept of Rheumatology

i@pkulakova.ruhttps://orcid.org/0000-0001-7958-5926ЛукинаГ. В.LukinaG. V.

Лукина Галина Викторовна, д. м. н., проф., зав. отделом ревматологии, руководитель; ведущий научный сотрудник лаборатории ревматоидного артрита и коморбидных инфекций

Lukina Galina V., Dr Med Sci (habil.), professor, head of Dept of Rheumatology, Head of the Moscow rheumatology center; leading researcher at the Laboratory of Rheumatoid Arthritis and Comorbid Infections

https://orcid.org/0000-0003-4074-5907АлександроваЕ. А.AlexandrovaE. A.

Александрова Елена Николаевна, д. м. н., зав. лабораторией клинической иммунологии

Alexandrova Elena N. Dr Med Sci (habil.), head of Dept of Clinical Immunology

https://orcid.org/0000-0002-2738-2956НовиковА. А.NovikovA. A.

Новиков Александр Александрович, д. б. н., ведущий научный сотрудник лаборатории клинической иммунологии

Novikov Alexandr A., Dr Bio Sci (habil.), leading researcher at Dept of Clinical Immunology

https://orcid.org/0000-0002-3674-8518БорисоваМ. А.BorisovaM. A.

Борисова Мария Александровна, к. м. н., старший научный сотрудник

Borisova Maria A., PhD Med Sci, senior researcher at Dept of Rheumatology

ГБУЗ «Московский клинический научный центр имени А. С. Логинова Департамента здравоохранения Москвы»РоссияA. S. Loginov Moscow Clinical Research Center, Moscow Department of HealthRussian FederationГБУЗ «Московский клинический научный центр имени А. С. Логинова Департамента здравоохранения Москвы»; ФГБНУ «Научно-исследовательский институт ревматологии им. В. А. Насоновой»РоссияA. S. Loginov Moscow Clinical Research Center, Moscow Department of Health; V. A. Nasonova Scientific and Research Institute of RheumatologyRussian Federation202624062026012Ревматология в общей врачебной практике (1)4448Copyright © Кулакова П.И., Лукина Г.В., Александрова Е.А., Новиков А.А., Борисова М.А., 20262026Кулакова П.И., Лукина Г.В., Александрова Е.А., Новиков А.А., Борисова М.А.Kulakova P.I., Lukina G.V., Alexandrova E.A., Novikov A.A., Borisova M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/5127

Цель исследования. Оценить возможность использования определения уровня фекального кальпротектина для ранней диагностики воспалительных заболеваний кишечника у пациентов с АС в реальной клинической практике. Материалы и методы. В анализ включены 70 пациентов с достоверным диагнозом АС старше 18 лет: мужчин 52 (74,3 %), женщин 18 (25,7 %) возрастом 47,4±8,8 года с длительностью заболевания 19,6±7,9 года. Всем пациентам проведены анализы крови (в том числе СОЭ, СРБ, HLAB 27 антиген), эзофагогастродуоденоскопия и колоноскопия, исследование уровня ФК с использованием метода латеральной иммунохроматографии экспресс-анализатором BUHLMANN Quantum Blue Calprotectin High Range assay с высокой чувствительностью 100 мкг/г кала и с диапазоном 100–1800 мкг/г кала. Результаты. У всех пациентов отмечалась высокая активность заболевания: BASDAI 5,4±1,4, ASDAS СРБ 3,6±0,8. ВЗК диагностировано в 18 случаях (25,7 %). У 77 % пациентов с АС уровень ФК превышал 100 мкг/г, у 28 % – более 1800 мкг/л. Уровень ФК составил более 1000 мкг/г у 63 %. У пациентов с ВЗК уровень ФК был более 100 мкг/г кала, cредний уровень ФК выше у пациентов с ВЗК (1141,3 мкг/г), чем без него (787 мкг/г). У всех пациентов с уровнем ФК менее 300 мкг/г/кала активного ВЗК не было обнаружено. Уровни ФК коррелировали с СРБ (r=0,366) и СОЭ (r=0,366) (p<0,001). Позитивный HLAB 27 антиген обнаружен у всех пациентов с ВЗК. Заключение. У пациентов с АС и ВЗК отмечались более высокие уровни ФК, чем у пациентов без ВЗК. Нормальные значения ФК у пациентов с АС свидетельствуют об отсутствии воспаления в кишечнике. Также отмечалась связь повышения уровня ФК с активностью АС.

The aim. To evaluate the possibility of using fecal calprotectin levels for early diagnosis of inflammatory bowel diseases in patients with AS in real clinical practice. Materials and methods. The analysis included 70 patients with a confirmed diagnosis of AS over the age of 18: 52 men (74.3 %) and 18 women (25.7 %), aged 47.4±8.8 years, with a disease duration of 19.6±7.9 years. All patients underwent blood tests (ESR, CRP, HLAB 27 antigen levels), esophagogastroduodenoscopy and colonoscopy, quantitative analysis of the fecal calprotectin levels using the method of lateral immunochromatography with the BUHLMANN Quantum Blue rapid test (standart range: 100–1800 μg/g). Results. All patients had high disease activity: BASDAI was 5.4±1.4, ASDAS CRP – 3.6±0.8. IBD was diagnosed in 18 cases (25.7 %). In 77 % of patients with AS, the FC level exceeded 100 μg/g, and in 28 % it exceeded 1800 μg/l. The FC level was more than 1000 μg/g in 63 %. In patients with IBD, the FC level was more than 100 μg/g, and the average FC level was higher in patients with IBD (1141.3 μg/g) than without IBD (787 μg/g). No active IBD was detected in all patients with FC levels less than 300 μg/g of feces. FC levels correlated with CRP (r=0.366) and ESR (r=0.366) (p<0.001). A positive HLAB 27 antigen was found in all patients with IBD. Conclusion. Patients with AS and IBD had higher FC levels than patients without IBD. Normal FC levels in patients with AS indicate the absence of intestinal inflammation. There was also a correlation between increased FC levels and the severity of AS. According to the study, measuring fecal calprotectin levels may be useful for detecting intestinal inflammation at an early stage.

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The authors declare that there are no conflicts of interest present.