血清学血小板/白蛋白、C反应蛋白/白蛋白评估克罗恩病黏膜愈合及疾病复发的价值

背景目前对克罗恩病(Crohn’s disease,CD)血清学标志物的研究较多的炎症性标志物主要为C反应蛋白,但无法用单独指标进行预测,近年来有研究发现血清标志物的联合应用可更准确的进行预测,且血清血小板/白蛋白(platelet/serum albumin,PLT/ALB)、C反应蛋白/白蛋白(C-reactive protein/serum albumin,CRP/ALB)值在评估炎症活动期等方面的特异性较高.目的探讨血清学血小板/白蛋白、C反应蛋白/白蛋白评估CD黏膜愈合及疾病复发的价值.方法选取新洲区人民医院2019-04/2021-04收治的85例CD患者.根据临床及内镜下愈合标准分为黏膜愈合组(n=44)和黏膜未愈合组(n=41),比较两组患者一般资料、治疗前及治疗6 mo后血清ALB、PLT、CRP、PLT/ALB、CRP/ALB水平及与SES-CD评分的相关性分析及评估黏膜愈合的价值,根据是否复发分为复发组和未复发组,比较两组血清指标水平及血清指标预测疾病复发的价值.结果2019-04/2021-04收治的85例CD患者经过6 mo治疗后,黏膜愈合组(n=44)中ALB水平较黏膜未愈合组(n=41)显著升高,而PLT、CRP水平显著降低,且PLT/ALB、CRP/ALB指标水平均降低,差异均具有统计学意义(P<0.05),血清ALB、PLT、CRP、PLT/ALB、CRP/ALB指标与SES-CD评分有明显相关性;采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评估,ALB、PLT、CRP、CRP/ALB及PLT/ALB评估黏膜愈合的ROC曲线与坐标轴形成面积(area under ROC curve,AUC)值分别为0.712、0.662、0.774、0.776、0.719(AUC>0.5);治疗6 mo后,复发组(n=45)ALB较未复发组(n=40)明显降低,而PLT、CRP、PLT/ALB、CRP/ALB水平升高,差异具有统计学意义(P<0.05);采用ROC曲线评估,ALB、PLT、CRP、CRP/ALB和PLT/ALB评估疾病复发的AUC值为0.641、0.628、0.643、0.652、0.651(AUC>0.5).结论血清学优化PLT/ALB、CRP/ALB指标在评估CD黏膜愈合及疾病复发的效果更佳,其临床价值高.

The Correlation among TIR, HbA1c,1, 5-AG and GA in Patients with 3rd Stage of Diabetic Nephropathy

Objective:To investigate the correlation among time in range(TIR),hemoglobinA1c(HbA1c),1,5-anhydroglucitol(1,5-AG)and glycated albumin(GA)in patients with 3rd stage of diabetic nephropathy.Methods:HbA1c,1,5-AG and GA were detected in120 patients with 3rd stage of diabetic nephropathy and flash glucose monitoring(FGM)was used to observe patients'TIR.The general characteristics,laboratory data and FGM blood glucose data of the groups≥70%and<70%of TIR3.9-10.0 were observed,and the correlation among TIR3.9-10.0,HbA1c,1,5-ag and GA was summarized.Results:There was no significant difference in general information and laboratory data in addition to glycemic monitoring indicators between the two groups of TIR3.9-10.0≥70%and TIR3.9-10.0<70%(P>0.05).After adjusting hemoglobin(HGB),TIR3.9-10.0 was negatively correlated with HbA1c,r=-0.871;after adjusting estimated glomerular filtration rate(eGFR),TIR3.9-10.0 was positively correlated with 1,5-AG concentration,r=0.591;after adjusting serum albumin(ALB),TIR3.9-10.0 was negatively correlated with GA concentration,r=-0.521;all P values were less than 0.05.Conclusion:TIR3.9-10.0 correlated with 1,5-AG and GA in patients with 3rd stage of diabetic nephropathy,which can be considered as an evaluation index of short-term glycemic control in patients with early diabetic nephropathy.