AFR与CAR在类风湿关节炎活动评估中的价值

Value of AFR and CAR in assessing activity of rheumatoid arthritis

目的探讨清蛋白与纤维蛋白原比值(AFR)和C反应蛋白与清蛋白比值(CAR)在类风湿关节炎(RA)活动中的作用。方法收集2017年1月至2019年12月在该院诊断为RA的162例患者(RA组)以及150例健康对照者(健康对照组)的实验室检测指标,根据C反应蛋白(CRP)计算的28个关节疾病活动指数(DAS28-CRP)评分标准将RA组分为活动组(98例)和缓解组(64例)。比较RA组和健康对照组、活动组和缓解组AFR、CAR的差异;分析AFR、CAR与清蛋白(Alb)、纤维蛋白原(Fib)、CRP、红细胞沉降率(ESR)等实验室指标以及RA疾病活动的相关性;采用受试者工作特征曲线(ROC曲线)分析指标单独及联合检测对RA疾病活动的诊断价值。结果RA组的AFR低于健康对照组,CAR高于健康对照组,差异有统计学意义(P<0.05);活动组的AFR低于缓解组,CAR高于缓解组,差异有统计学意义(P<0.05);AFR与DAS28-CRP评分呈负相关(r=-0.409,P<0.05),CAR和DAS28-CRP评分呈正相关(r=0.457,P<0.05);AFR、CAR单独及联合检测诊断RA疾病活动的ROC曲线下面积分别为0.775、0.782、0.806。结论AFR和CAR可作为炎症指标用于监测RA疾病活动。

Objective To investigate the role of albumin to fibrinogen ratio(AFR)and C-reactive protein to albumin ratio(CAR)in the activity of rheumatoid arthritis(RA).Methods The laboratory test indicators were collected from 162 patients with RA(RA group)and 150 healthy controls(healthy control group)from January 2017 to December 2019.The RA group was divided into the activity group(98 cases)and remission group(64 cases)according to the DAS28-CRP scoring standard calculated by CRP.The differences of AFR and CAR were compared between the RA group with healthy control group,and between activity group with remission group.Furthermore,the correlation between AFR and CAR with the laboratory indicators of Alb,Fib,CRP and ESR as well as disease activity of RA was analyzed.The receiver operating characteristic(ROC)curve was adopted to analyze the diagnostic value of single indicator and combined indicators detection for the activity of RA.Results AFP in the RA group was lower than that in the healthy control group,CAR was higher than that in the healthy control group,and the differences were statistically significant(P<0.05);AFP in the active group was lower than that in the remission group,CAR in the active group was higher that in the remission group and the differences were statistically significant(P<0.05).AFR was negatively correlated with the DAS28-CRP score(r=-0.409,P<0.05),while CAR was positively correlated with the DAS28-CRP score(r=0.457,P<0.05).The areas under the ROC curve of single detection and combined detection of AFR and CAR for diagnosing the activity of RA were 0.775,0.782 and 0.806 respectively.Conclusion AFR and CAR can serve as the inflammatory indicators for monitoring the disease activity of RA.