血清TNF-α、hs-CRP、IL-22在儿童克罗恩病疾病活动度和预后评估中的作用

doi:10.3969/j.issn.1673-8640.2026.04.012

摘要/Abstract

摘要：

目的探讨血清肿瘤坏死因子-α（TNF-α）、高敏C反应蛋白（hs-CRP）和白细胞介素-22（IL-22）与儿童克罗恩病（CD）疾病活动度和预后的关系。方法选取2017年1月—2022年6月郑州大学附属儿童医院CD患儿63例（CD组）、健康体检儿童63名（正常对照组）。检测所有研究对象血清TNF-α、hs-CRP、IL-22水平。根据儿童克罗恩病活动指数（PCDAI）评分将所有患儿分为非活动组（26例）和活动组（37例）。对所有患儿随访1年，根据预后情况将其分为预后不良组（24例）和预后良好组（39例）。采用Pearson相关分析评估CD患儿血清TNF-α、hs-CRP、IL-22 水平与PCDAI评分的相关性。采用受试者工作特征（ROC）曲线评价血清TNF-α、hs-CRP、IL-22判断CD患儿预后不良的效能。结果 CD组血清TNF-α、hs-CRP、IL-22水平均高于正常对照组（P<0.05）。活动组PCDAI评分和血清TNF-α、hs-CRP、IL-22水平均高于非活动组（P<0.05）。CD患儿的PCDAI评分与血清TNF-α、hs-CRP、IL-22水平均呈正相关（r值分别为0.595、0.656、0.643，P<0.001）。预后不良组血清TNF-α、hs-CRP、IL-22水平均高于预后良好组（P<0.001）。血清TNF-α、hs-CRP、IL-22水平升高是CD患儿发生预后不良的危险因素（P<0.05）。血清TNF-α、hs-CRP、IL-22单项检测和联合检测判断CD患儿预后不良的曲线下面积（AUC）分别为0.686、0.752、0.682、0.848。结论血清TNF-α、hs-CRP、IL-22水平与儿童CD疾病活动度和预后均密切相关，或可作为CD疾病活动度和预后评估的指标。

关键词: 肿瘤坏死因子-α, 高敏C反应蛋白, 白细胞介素-22, 克罗恩病, 疾病活动度, 预后, 儿童

Abstract:

Objective To investigate the relationship between serum tumor necrosis factor-alpha（TNF-α），high-sensitivity C-reactive protein（hs-CRP）and interleukin-22（IL-22）and the disease activity and prognosis of pediatric Crohn's disease（CD）. Methods Totally，63 children with CD（CD group）and 63 healthy children（healthy control group） were enrolled from January 2017 to June 2022 at the Children's Hospital of Zhengzhou University. The levels of serum TNF-α，hs-CRP and IL-22 were determined. All the children were classified into non-active group（26 cases）and active group（37 cases）based on the pediatric Crohn's disease activity index（PCDAI）score. All the children were followed up for 1 year，and they were classified into poor prognosis group（24 cases）and good prognosis group（39 cases）based on the prognosis. Pearson correlation analysis was used to evaluate the correlation between the levels of serum TNF-α，hs-CRP and IL-22 and the PCDAI score in children with CD. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of serum TNF-α，hs-CRP and IL-22 in predicting poor prognosis in children with CD. Results The levels of serum TNF-α，hs-CRP and IL-22 in CD group were higher than those in healthy control group（P<0.05）. The PCDAI score and the levels of serum TNF-α，hs-CRP and IL-22 in active group were higher than those in non-active group（P<0.05）. The PCDAI score in children with CD was positively correlated with the levels of serum TNF-α，hs-CRP and IL-22（r values were 0.595，0.656 and 0.643，respectively，P<0.001）. The levels of serum TNF-α，hs-CRP and IL-22 in poor prognosis group were higher than those in good prognosis group （P<0.001）. Elevated levels of serum TNF-α，hs-CRP and IL-22 were risk factors for poor prognosis in children with CD（P<0.05）. The areas under curves（AUC）of serum TNF-α，hs-CRP，IL-22 single and combined determinations in predicting poor prognosis in children with CD were 0.686，0.752，0.682 and 0.848，respectively. Conclusions The levels of serum TNF-α，hs-CRP and IL-22 are related to the disease activity and prognosis of pediatric CD and may be used as the indicators for assessing the disease activity and prognosis of pediatric CD.

Key words: Tumor necrosis factor-alpha, High-sensitivity C-reactive protein, Interleukin-22, Crohn's disease, Disease activity, Prognosis, Children

中图分类号:

R446.1

王向辉, 李小芹, 薛福敏. 血清TNF-α、hs-CRP、IL-22在儿童克罗恩病疾病活动度和预后评估中的作用[J]. 检验医学, 2026, 41(4): 386-390.

WANG Xianghui, LI Xiaoqin, XUE Fumin. Roles of serum TNF-α，hs-CRP and IL-22 in assessing disease activity and prognosis in children with Crohn's disease[J]. Laboratory Medicine, 2026, 41(4): 386-390.

图/表 7

参考文献 18

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组别	例数	TNF-α/ （pg·mL-1）	hs-CRP/ （mg·L-1）	IL-22/ （pg·mL-1）
正常对照组	63	4.91±1.15	6.61±1.85	7.53±1.88
CD组	63	10.54±3.28	12.89±3.10	14.01±2.87
t值		12.857	13.808	14.991
P值		<0.001	<0.001	<0.001

组别	例数	TNF-α/ （pg·mL-1）	hs-CRP/ （mg·L-1）	IL-22/ （pg·mL-1）
正常对照组	63	4.91±1.15	6.61±1.85	7.53±1.88
CD组	63	10.54±3.28	12.89±3.10	14.01±2.87
t值		12.857	13.808	14.991
P值		<0.001	<0.001	<0.001

组别	例数	PCDAI评分/分	TNF-α/（pg·mL-1）	hs-CRP/（mg·L-1）	IL-22/（pg·mL-1）
活动组	37	24.99±8.23	12.00±2.93	14.31±2.41	15.01±2.53
非活动组	26	5.60±3.23	8.47±2.60	10.87±2.87	12.58±2.75
t值		11.391	4.927	5.154	3.621
P值		<0.001	<0.001	<0.001	0.001

组别	例数	PCDAI评分/分	TNF-α/（pg·mL-1）	hs-CRP/（mg·L-1）	IL-22/（pg·mL-1）
活动组	37	24.99±8.23	12.00±2.93	14.31±2.41	15.01±2.53
非活动组	26	5.60±3.23	8.47±2.60	10.87±2.87	12.58±2.75
t值		11.391	4.927	5.154	3.621
P值		<0.001	<0.001	<0.001	0.001

组别	例数	性别		年龄/岁	治疗药物		TNF-α/ （pg·mL-1）	hs-CRP/ （mg·L-1）	IL-22/ （pg·mL-1）
组别	例数	男/例	女/例	年龄/岁	免疫抑制剂/例	生物制剂/例	TNF-α/ （pg·mL-1）	hs-CRP/ （mg·L-1）	IL-22/ （pg·mL-1）
预后不良组	24	15	9	8.92±1.74	12	6	12.02±3.33	14.58±2.07	15.33±2.40
预后良好组	39	20	19	8.26±2.01	16	7	9.63±2.93	11.85±3.18	13.45±2.78
统计值		0.757		1.330	0.485	0.451	2.984	3.740	2.740
P值		0.384		0.188	0.486	0.502	0.004	<0.001	<0.001