炎症性肠病患者C反应蛋白/白蛋白比值与疾病活动性的相关性研究

The relationship between C-reactive protein/albumin ratio and disease activity in patients with inflammatory bowel disease

目的:探讨C反应蛋白/白蛋白比值(CRP/ALB)、炎症标志物和全血计数水平与炎症性肠病(IBD)活动性的相关性。方法:将2015年1月—2020年12月诊治的584例IBD患者纳入研究,其中溃疡性结肠炎(UC)183例,克罗恩病(CD)401例,分析血清CRP、ALB、血沉(ESR)和全血计数与IBD的关系,采用Mayo评分和Crohn疾病活动指数分别评估UC和CD患者的疾病活动性。结果:活动期IBD患者的CRP/ALB比值、CRP、ESR、血小板/淋巴细胞比值(PLR)、红细胞分布宽度、中性粒细胞/淋巴细胞比值(NLR)明显高于缓解期,而ALB和淋巴细胞/单核细胞比值(LMR)明显低于缓解期(P<0.05)。受试者工作特征曲线分析结果显示,活动期UC和CD的CRP/ALB比值的最佳截断值分别为0.17和0.42,敏感性分别为67.9%和75.7%,特异性分别为86.5%和92.1%。多因素logistic回归分析显示,在调整炎症标志物(ESR、NLR、PLR和LMR)后,CRP/ALB比值在区分UC和CD疾病活动性上差异有统计学意义(P<0.001)。结论:CRP/ALB比值水平与IBD疾病活动性密切相关,可用于UC和CD疾病活动性的评估。

Objective:To evaluate the C-reactive protein/albumin ratio(CRP/ALB),inflammatory markers,and complete blood count parameters in patients with inflammatory bowel disease(IBD) and their relationship with disease activity.Methods:A total of 584 patients with IBD treated in our hospital from January 2015 to December 2020 were included,including 183 cases of ulcerative colitis(UC) and 401 cases of Crohn’s disease(CD).The relationship between serum C-reactive protein(CRP),albumin(ALB),erythrocyte sedimentation rate(ESR) and whole blood count and IBD was analyzed.The Mayo score and Crohn’s disease activity index were used to evaluate the disease activity of UC and CD patients,respectively.The relationship between the above parameters and disease activity was discussed.Results:The CRP/ALB ratio,CRP,ESR,platelet/lymphocyte ratio(PLR),red blood cell distribution width,neutrophil/lymphocyte ratio(NLR) of patients with active IBD were significantly higher than those of patients with stable IBD,while ALB and lymphocyte/monocyte ratio(LMR) were significantly lower than that of patients with stable IBD(P<0.05).ROC curve analysis results showed that the best cut-off values of CRP/ALB ratio for active UC and CD were 0.17 and 0.42,respectively,the sensitivity was 67.9% and 75.7%,and the specificity was 86.5% and 92.1%,respectively.Multivariate logistic regression analysis showed that after adjusting these inflammatory markers(ESR,NLR,PLR and LMR),the CRP/ALB ratio was a statistically significant parameter to distinguish the disease activity of UC and CD(P<0.001).Conclusion:The CRP/ALB ratio is closely related to IBD disease activity.