胃と腸58巻6号

2023年06月発行

今月の主題 分類不能腸炎（IBDU）の現状と将来展望 主題研究

非特異性多発性小腸潰瘍症診断における尿中プロスタグランジンE主要代謝産物（PGE-MUM）の有用性

著者： 松野雄一¹ 梅野淳嗣¹ 鳥巣剛弘¹ 冬野雄太¹ 岡本康治² 安川重義³ 平井郁仁⁴ 渡辺憲治⁵ 細江直樹⁶ 河内修司⁷ 蔵原晃一⁸ 八尾恒良⁹ 松本主之¹⁰ 江﨑幹宏¹¹

所属機関： ¹九州大学大学院医学研究院病態機能内科学 ²九州中央病院消化器内科 ³福岡大学筑紫病院消化器内科 ⁴福岡大学医学部消化器内科学講座 ⁵兵庫医科大学病院消化管内科 ⁶慶應義塾大学医学部内視鏡センター ⁷千早病院内科 ⁸松山赤十字病院胃腸センター ⁹佐田厚生会佐田病院消化器内科 ¹⁰岩手医科大学医学部内科学講座消化器内科分野 ¹¹佐賀大学医学部内科学講座消化器内科

ページ範囲：P.773 - P.781

要旨●非特異性多発性小腸潰瘍症（CEAS）は持続的な出血に起因する慢性の貧血と低蛋白血症を特徴とする比較的まれな遺伝性疾患である．小腸に多発潰瘍を来すためCrohn病（CD）との鑑別が必要であるが，全例で遺伝学的検査を行うことは現実的でないため，簡便かつ非侵襲的なスクリーニング検査法が必要とされている．今回筆者らは，CEASとCDの鑑別における尿中プロスタグランジンE主要代謝産物（PGE-MUM）濃度の有用性について検討した．CEAS 20例とCD 98例を対象とした．PGE-MUM濃度はCD患者と比較しCEAS患者において有意に高値であった（中央値102.7 vs 27.9μg/g×Cre，p<0.0001）．ROC解析では至適カットオフ値は48.9μg/g×Creと算出され，その際の感度は95.0%，特異度は79.6%であった．PGE-MUMは，CEASとCDの鑑別において有用な検査であると考えられた．

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