纤维蛋白原与清蛋白比值在溃疡性结肠炎诊断及病情评估中的应用研究

Application of fibrinogen-albumin ratio in the diagnosis and illness evaluation of ulcerative colitis

目的探讨纤维蛋白原(FIB)与清蛋白(ALB)比值(FAR)在溃疡性结肠炎(UC)诊断及病情评估中的应用价值。方法选取2014年3月—2021年4月在温州医科大学附属第二医院就医的溃疡性结肠炎患者76例(溃疡性结肠炎组)及体检健康者160例(对照组)作为研究对象。分析2组间FAR差异,并通过ROC曲线评价FAR对溃疡性结肠炎的诊断价值;通过改良的Mayo评分系统评估溃疡性结肠炎疾病活动度,结肠镜确定病变蔓延部位,评估FAR与疾病活动度及病变蔓延部位的相关性。采用相关性分析研究FAR与传统炎症指标C-反应蛋白(CRP)、红细胞沉降率(ESR)、中性粒细胞(N)与淋巴细胞(L)比值(NLR)、FIB之间的相关性。结果溃疡性结肠炎组FAR显著高于对照组(P<0.01)。通过ROC曲线分析,当最佳临界值为68.354时,FAR诊断UC的灵敏度和特异度分别为0.618和0.819,其曲线下面积(AUC)为0.747(95%CI:0.671~0.823)。UC中度和重度患者FAR较轻度患者升高明显(P<0.05)。全结肠受累患者FAR高于直肠/乙状结肠受累或左半结肠受累患者(P<0.05)。FAR与CRP、ESR、NLR、FIB均呈正相关。结论临床中FAR可以作为一种新指标,应用于初步诊断和评估UC活动度及病变范围。其简便、无创、易于检测,值得临床推广应用。

Objective To investigate the value of fibrinogen-albumin ratio(FAR)in the diagnosis and illness evaluation of ulcerative colitis(UC).Methods From March 2014 to April 2021,76 patients with ulcerative colitis(ulcerative colitis group)and 160 healthy people(control group)hospitalized in the Second Affiliated Hospital of Wenzhou Medical University were selected as the research objects.The difference in FAR between the two groups was analyzed,and the diagnostic value of FAR for ulcerative colitis was evaluated by ROC curve.The disease activity of ulcerative colitis was evaluated by modified Mayo scoring system,and pathological spreading site was determined by colonoscopy.The correlation of FAR with disease activity and pathological spreading site was evaluated.Correlation analysis was used to study the correlation between FAR and inflammatory markers including CRP,ESR,NLR and FIB.Results FAR of ulcerative colitis group was significantly higher than that of the control group(P<0.01).By ROC curve analysis,when the cut-off value was 68.354,the sensitivity and specificity of FAR in the diagnosis of UC were 0.618 and 0.819 respectively,and the area under ROC curve was 0.747(95%CI:0.671-0.823).FAR was significantly higher in moderate and severe UC cases than that in the mild cases(P<0.05).FAR of UC patients with entire colon involvement was higher than that of UC patients with rectal/sigmoid colon involvement or left colon involvement(P<0.05).FAR was positively correlated with CRP,ESR,NLR and FIB.Conclusion FAR could be used as a new marker for the diagnosis and illness evaluation of UC.It is simple,non-invasive and easy to detect,which is worthy of clinical application.