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目的 探讨粪便钙卫蛋白对儿童溃疡性结肠炎(UC)诊断及治疗的指导作用。方法 选取UC患儿57例(UC组),单纯腹泻患儿30例(腹泻组),健康儿童60例(健康对照组)。留取粪便,采用ELISA法检测钙卫蛋白。 UC组采用“升阶梯”方案(美沙拉嗪无效时加用激素,继而加用单克隆抗体)治疗,比较治疗前后粪便钙卫蛋白变化,分析钙卫蛋白诊断UC的效能及其与治疗的关系。结果 UC组、腹泻组、健康对照组中位粪便钙卫蛋白分别为307.93、124.95和19.17μg/g,UC组明显高于腹泻组和健康对照组(P均<0.01),腹泻组与健康对照组比较无统计学差异(P>0.05)；UC组活动期、缓解期患儿中位粪便钙卫蛋白分别为333.53、273.50μg/g,P<0.05；ROC曲线分析显示粪便钙卫蛋白升高的临界值为175.53μg/g,对应诊断UC的最佳灵敏度和特异度分别为77.2%和87.9%。 UC组治疗后活动期患儿中位粪便钙卫蛋白明显下降；中位粪便钙卫蛋白≥307.93μg/g者激素使用率、用药时间长于<307.93μg/g者(P均<0.05)。结论粪便钙卫蛋白诊断儿童UC准确、无创、安全,有助于临床选择治疗药物及判断治疗效果. [ABSTRACT FROM AUTHOR]