C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.

C-reactive Protein/Albumin Ratio as a Prognostic Indicator in Posttraumatic Shock and Outcome of Multiple Trauma Patients

Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multiple trauma patients.Methods A total of 264 adult patients with severe multiple trauma were included for the present retrospective study,together with the collection of relevant clinical and laboratory data.CAR,CRP,albumin,shock index and ISS were incorporated into the prognostic model,and the receiver operating characteristic(ROC)curve was drawn.Then,the shock index for patients with different levels of CAR was analyzed.Finally,univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for the 28-day mortality of multiple trauma patients.Results A total of 36 patients had poor survival outcomes,and the mortality rate reached 13.6%.Furthermore,after analyzing the shock index for patients with different levels of CAR,it was revealed that the shock index was significantly higher when CAR was≥4,when compared to CAR<2 and 2≤CAR<4,in multiple trauma patients.The multivariate logistic analysis helped to identify the independent association between the variables CAR(P=0.029)and shock index(P=0.019),and the 28-day mortality of multiple trauma patients.Conclusion CAR is higher in patients with severe multiple trauma.Furthermore,CAR serves as a risk factor for independently predicting the 28-day mortality of multiple trauma patients.The shock index was significantly higher when CAR was≥4 in multiple trauma patients.

The prognostic potential of pretreatment C-reactive protein to albumin ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma

Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.

Prognostic role of C-reactive protein to albumin ratio in lung cancer:An updated systematic review and meta-analysis

Background: C-reactive protein to albumin ratio(CRP/Alb ratio,CAR)has been suggested as a potential prognostic biomarker in lung cancer.This updated systematic review and meta-analysis aimed to assess the association between CAR and lung cancer prognosis in current literature.Methods: A systematic search of databases was conducted to identify relevant studies published up to April 2023.Pooled hazard ratios(HRs)and 95%confidence intervals(CIs)were calculated to assess the association between CAR and overall survival(OS)and progression-free survival(PFS)and recurrence-free survival(RF)in lung cancer patients.Results: This meta-analysis includes 16 studies with a total of 5337 patients,indicating a significant association between higher CAR and poorer OS,PFS,and RFS in lung cancer patients,with a pooled HR of 1.78(95%CI=1.60-1.99),1.57(95%CI=1.36-1.80),and 1.97(95%CI=1.40-2.77),respectively.Conclusions: This updated meta-analysis provides evidence for the potential prognostic role of CAR in lung cancer,suggesting its utility as an effective and noninvasive biomarker for identifying high-risk patients and informing treatment decisions in a cost-effective manner.However,further large-scale studies will be necessary to establish the optimal cut-off value for CAR in lung cancer and confirm the present findings.

Cross-sectional association of serum C-reactive protein and uric acid with albuminuria in Chinese type 2 diabetic patients

Background Evidences show that subclinical chronic inflammation is involved in the pathogenesis of diabetic nephropathy. The aim of this study was to examine the relationship between serum C-reactive protein （CRP）, serum uric acid, and albuminuria in Chinese type 2 diabetic patients.

降钙素原与C-反应蛋白/血清白蛋白比值对结直肠癌术后患者吻合口漏的预测

结直肠癌是消化道中较为常见的恶性肿瘤,其目前多采用手术切除的方式进行治疗,术后吻合口漏(anastomotic leakage,AL)是外科手术常见感染性并发症。术后发生AL会影响患者预期化学治疗时间,增加患者经济负担及二次手术可能,延长住院时长,加剧医患矛盾等。炎症指标可用于AL的早期预测,便于临床科室给予治疗方案。降钙素原(procalcitonin,PCT)是具有广泛生物学活性的多效性蛋白质,在结直肠癌术后AL的预测或排除中有重要作用,C-反应蛋白/血清白蛋白比值(C-reactive protein/serum albumin ratio,CAR)是反映全身炎症、免疫水平和营养状态的重要指标。二者均在早期对AL的预测有效,二者的联合应用可能存在更大的预测价值。

Prognostic value of a nomogram model for postoperative liver metastasis of colon cancer

BACKGROUND Colon cancer is one of the most common malignant tumors of the digestive system.Liver metastasis after colon cancer surgery is the primary cause of death in patients with colon cancer.AIM To construct a novel nomogram model including various factors to predict liver metastasis after colon cancer surgery.METHODS We retrospectively analyzed 242 patients with colon cancer who were admitted and underwent radical resection for colon cancer in Zhejiang Provincial People’s Hospital from December 2019 to December 2022.Patients were divided into liver metastasis and non-liver metastasis groups.Sex,age,and other general and clinicopathological data(preoperative blood routine and biochemical test indexes)were compared.The risk factors for liver metastasis were analyzed using singlefactor and multifactorial logistic regression.A predictive model was then constructed and evaluated for efficacy.RESULTS Systemic inflammatory index(SII),C-reactive protein/albumin ratio(CAR),red blood cell distribution width(RDW),alanine aminotransferase,preoperative carcinoembryonic antigen level,and lymphatic metastasis were different between groups(P<0.05).SII,CAR,and RDW were risk factors for liver metastasis after colon cancer surgery(P<0.05).The area under the curve was 0.93 for the column-line diagram prediction model constructed based on these risk factors to distinguish whether liver metastasis occurred postoperatively.The actual curve of the column-line diagram predicting the risk of postoperative liver metastasis was close to the ideal curve,with good agreement.The prediction model curves in the decision curve analysis showed higher net benefits for a larger threshold range than those in extreme cases,indicating that the model is safer.CONCLUSION Liver metastases after colorectal cancer surgery could be well predicted by a nomogram based on the SII,CAR,and RDW.

The Clinical Value of NLR, D-D and CRP/ALB Ratio in the Diagnosis of Pulmonary Thromboembolism

Objective: To evaluate the clinical diagnostic value of C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR) and D-dimer (D-D) in patients with pulmonary thromboembolism (PTE). Methods: We conducted a retrospective analysis comparing hematology and coagulation in 362 PTCA-confirmed PTE patients with the control group and analyzing their relationships with CAR, NLR, and D-D. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic threshold, area under the curve (AUC), diagnostic sensitivity and specificity of CAR, NLR and D-D for PTE. Results: 1) CAR, NLR and D-D levels in PTE patients were 2.13 ± 2.08, 8.96 ± 1.94 and 9.69 ± 8.61 respectively, significantly higher than those in control group (CAR = 0.03 ± 0.01, t = 20.7736, P < 0.01;NLR = 1.76 ± 0.53, t = 2.4281, P < 0.05 and PTE = 0.20 ± 0.11, t = 3.0066, P < 0.01 respectively). 2) NLR was positively correlated with CAR (r = 0.2111, t = 4.0971, P < 0.01) and D-D (r = 0.1065, t = 2.0481, P < 0.05), but CAR was not correlated with D-D (r = 0.0975, P > 0.05). 3) The levels of HB, LY, PLT and AT in PTE patients were significantly lower than those in control group, while WBC, NE and FB were significantly higher than those in control group. 4) CAR was negatively correlated with Hb and AT (P all < 0.01), but positively correlated with WBC, NE, MO and FB (P all < 0.01). NLR was negatively correlated with LY and AT (P all < 0.01), but positively correlated with WBC, NE and FB (P all < 0.01). DD was negatively correlated with Hb and PLT (P all < 0.05), but positively correlated with WBC, NE and MO (P all < 0.01). Conclusion: The levels of Hb, LY, PLT and AT were significantly decreased in PTE patients, while WBC, NE and FB were significantly increased. CAR, NLR and D-D were highly expressed in PTE patients, and were closely correlated with Hb, AT and FB. Combined detection of CAR, NLR and D-D can improve the diagnostic value of PTE.

血清C反应蛋白和清蛋白比值与急性脑梗死患者颈动脉狭窄的关系研究

目的探讨血清C反应蛋白和清蛋白比值(CAR)与急性脑梗死(ACI)患者颈动脉狭窄(CAS)程度之间的关系。方法收集2021年1月至2021年12月青海省人民医院首次发生ACI并经全脑数字减影血管造影术(DSA)检查的中老年住院患者285例,根据DSA检查后有无CAS分为对照组(74例)及狭窄组(211例),并根据狭窄程度将狭窄组分为3个亚组:轻度狭窄组(狭窄率<50%,79例)、中度狭窄组(50%≤狭窄率<70%,65例)、重度狭窄及闭塞组(狭窄率≥70%,67例);对比分析对照组与狭窄组、以及与狭窄组中各亚组的基线资料及实验室检查指标的差异,采用二元有序Logistic回归分析影响ACI患者CAS严重程度的危险因素。采用受试者工作特征(ROC)曲线评估CAR对ACI患者发生CAS的诊断价值。结果狭窄组CAR高于对照组(P<0.05);重度狭窄及闭塞组CAR明显高于对照组、轻度度狭窄组及中度狭窄组,中度狭窄组CAR明显高于对照组及轻度狭窄组,轻度狭窄组CAR明显高于对照组(均P<0.05)。采用二元有序Logistic回归分析发现CAR为ACI患者CAS的危险因素(P<0.05)。ROC曲线显示,CAR诊断ACI患者发生CAS的最佳截断值为0.331,曲线下面积(AUC)为0.703(95%CI:0.639~0.768,P<0.05),其诊断ACI患者发生CAS的灵敏度为68.2%,特异度为64.9%。结论CAR与ACI患者发生CAS存在一定联系,CAR可作为诊断ACI患者发生CAS的可靠指标。

脓毒症患者hs-CRP/ALB和hs-CRP/PA与膈肌功能障碍的相关性

目的探讨超敏C反应蛋白与血清白蛋白比值(hs-CRP/ALB)和超敏C反应蛋白与前白蛋白比值(hs-CRP/PA)与脓毒症膈肌功能障碍的相关性。方法采用前瞻性观察性研究方法,选择2020年1月至2021年5月入住宁夏医科大学总医院重症医学科(ICU)的80例脓毒症患者为研究对象,以入ICU第1天床旁超声测量膈肌位移(diaphragmatic excursion,DE)<10 mm诊断为膈肌功能障碍,将其分为脓毒症膈肌功能障碍组(n=29)和脓毒症非膈肌功能障碍组(n=51),并选择年龄、性别与研究对象相匹配的30例普通术后非脓毒症患者和15例健康志愿者为术后对照组和正常对照组。收集临床资料,动态观察脓毒症患者超敏C反应蛋白(hyper-sensitive C-reactive protein,hs-CRP)、血清白蛋白(albumin,ALB)、前白蛋白(prealbumin,PA)等指标,计算hs-CRP/ALB和hs-CRP/PA。并用间接测热法测量脓毒症患者静息能量消耗水平,计算静息能量消耗水平与实际给予能量的差值,即能量缺失值。结果①入ICU第1天,脓毒症膈肌功能障碍组、脓毒症非膈肌功能障碍组和术后对照组DE均低于正常对照组(均P<0.05),且脓毒症膈肌功能障碍组DE低于脓毒症非膈肌功能障碍组和术后对照组[mm:8.8(6.7,9.3)vs.13.3(12.3,17.8)和12.9(10.5,15.7),P<0.05];脓毒症膈肌功能障碍组能量缺失值高于脓毒症非膈肌功能障碍组(P<0.05)。②入ICU第1、3、7天,脓毒症膈肌功能障碍组hs-CRP/ALB高于脓毒症非膈肌功能障碍组[第1天:7.73(3.95,9.15)vs.5.44(2.76,8.14);第3天:4.63(3.12,6.17)vs.2.60(1.04,5.09);第7天:2.21(0.84,5.84)vs.0.81(0.52,2.36),均P<0.05]。脓毒症膈肌功能障碍组hs-CRP和hs-CRP/PA仅入ICU第3天高于脓毒症非膈肌功能障碍组[hs-CRP(mg/L):150.0(92.4,169.0)vs.62.5(30.3,152.0);hs-CRP/PA:1.74(1.12,2.73)vs.0.78(0.21,1.97),均P<0.05]。两组间各时相点ALB、PA比较差异均无统计学意义(均P>0.05)。脓毒症膈肌功能障碍组入ICU第1天hs-CRP/ALB、hs-CRP/PA均高于第7天(P<0.05)。③脓毒症患者DE与各指标相关分析:入ICU第1、3、7天,DE均与hs-CRP/ALB呈负相关(r分别为-0.241、-0.373、-0.465,均P<0.05);入ICU第3、7天,DE均与hs-CRP/PA呈负相关(r分别为-0.325、-0.468,均P<0.05)。结论脓毒症患者血清hs-CRP/ALB、hs-CRP/PA与膈肌功能障碍呈负相关。

血清PGRN、HIF-1α和HCAR对慢性阻塞性肺疾病再次急性加重的临床评估意义

目的探讨血清颗粒蛋白前体(PGRN)、缺氧诱导因子(HIF)-1α、超敏C反应蛋白(hsCRP)与白蛋白(ALB)比值(HCAR)在慢性阻塞性肺疾病急性加重(AECOPD)患者中的表达及预测再次急性加重的价值。方法选取2021年1月—2022年6月于徐州市贾汪区人民医院治疗的AECOPD患者共60例作为AECOPD组,选取同期体检健康者30例为健康对照组。采集外周血2 ml,检测血清PGRN、HIF-1α水平;收集AECOPE组入院时人口学资料、动脉血气分析、血常规结果、hsCRP和ALB,计算HCAR。出院后定期随访。根据180 d内再次急性加重情况,将研究对象划分为再次急性加重组和无再次急性加重组。单因素logistic回归分析各指标与再次急性加重的关系。通过绘制受试者工作特征曲线(ROC),分析血清PGRN、HIF-1α、HCAR预测患者再次急性加重的临床价值。结果AECOPD组血清PGRN浓度、HIF-1α浓度、HCAR较健康对照组显著升高,差异有统计学意义(P<0.05)。AECOPD患者中呼吸衰竭组血清PGRN浓度、HIF-1α浓度、HCAR较无呼吸衰竭组显著增高,差异有统计学意义(P<0.05)。单因素logistic回归分析提示血清PGRN和HIF-1α是AECOPD再次急性加重的危险因素。ROC曲线分析发现,血清PGRN联合HIF-1α的曲线下面积(AUC)为0.84,显著高于血清HIF-1α的AUC(0.68,P<0.05),但是相比于血清PGRN的AUC(0.71),差异无统计学意义(P>0.05)。结论血清PGRN、HIF-1α浓度、HCAR能反映AECOPD患者病情的严重程度,血清PGRN联合HIF-1α对预测AECOPD再次急性加重具有较高的特异性。

C-反应蛋白/血清白蛋白联合D-二聚体预测急性胰腺炎严重程度的临床价值研究

目的探索C-反应蛋白(CRP)/血清白蛋白比值(CAR)及D-二聚体(D-dimer)联合应用对急性胰腺炎(AP)严重程度的预测价值。方法回顾性分析2020年1月至2021年12月在孝感市中心医院住院治疗的246例AP患者的临床资料,其中206例患者为非重症急性胰腺炎组,40例为重症急性胰腺炎组(SAP组),收集所有患者的病历资料、临床指标进行统计学分析。结果入院时的体温、呼吸频率、白细胞、淋巴细胞、血淀粉酶、谷丙转氨酶、谷草转氨酶、血脂肪酶、总胆红素组间比较差异无统计学意义(P>0.05),入院时的心率、中性粒细胞、D-二聚体、降钙素原、血肌酐、CRP、血尿素氮、血清白蛋白、血糖及CAR组间比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析发现,CAR、D-二聚体是SAP的重要预测因子(P<0.05)。入院时CAR与急性胰腺炎严重程度床边指数(BISAP)评分成正相关(r=0.370,P<0.05),D-二聚体与BISAP评分成正相关(r=0.445,P<0.05)。受试者工作特征(ROC)曲线结果显示,CAR预测SAP的曲线下面积为0.835(95%CI:0.770~0.901),灵敏度75.00%,特异度分别为85.9%;D-二聚体预测SAP的曲线下面积为0.809(95%CI:0.731~0.887),灵敏度为80%,特异度为71.4%;CAR、D-二聚体两者联合预测SAP的曲线下面积为0.891(95%CI:0.847~0.936),灵敏度为77.5%,特异度为87.4%。结论CAR、D-二聚体预测AP病情严重程度方面有着明显的优势,尤其当两者联合检测时其预测效能进一步增加。

南疆三种绵羊血清蛋白电泳分析

本研究采用醋酸纤维素薄膜电泳法测定了新疆南部三种绵羊血清蛋白及其各组份的含量。结果表明 :新疆南部肉脂兼用型多浪羊血清总蛋白含量高 ,清球比值低。羔皮型卡拉库尔羊清球比高。但三种绵羊血清总蛋白含量和清球比的差异均不显著。而位于高寒区的肉脂兼用型巴音布鲁克羊γ -球蛋白的含量明显高于其它两种绵羊 ,差异显著。

血清C-反应蛋白／白蛋白比值对急性胰腺炎患者预后的预测作用

目的探讨血清C-反应蛋白／白蛋白比值（CAR）对急性胰腺炎患者预后的预测作用。方法回顾性分析258例徐州市第一人民医院就诊的急性胰腺炎患者，同时选择年龄、性别等配对的258例正常健康体检者作为对照。提取就诊时研究对象的性别、年龄、白细胞计数、中性粒细胞计数、淋巴细胞计数、降钙素原、C-反应蛋白、血清白蛋白值，计算中性粒细胞／淋巴细胞比值（NLR）、CAR。统计分析NLR、降钙素原、C-反应蛋白、CAR与急性胰腺炎患者病情严重程度及预后的关系。结果与健康对照组相比，急性胰腺炎患者的白细胞计数、NLR、降钙素原、C-反应蛋白以及CAR明显升高（P〈0．05），但淋巴细胞计数明显降低（P〈0．05）。急性胰腺炎病情越严重、合并全身炎症反应综合征、院内死亡的患者，NLR、降钙素原、C-反应蛋白、CAR也越高（P〈0．05）。CAR在预测急性胰腺炎患者预后的特异性、敏感性、约登指数更高。结论血清CAR可预测急性胰腺炎患者预后，其检测特异性、敏感性较目前常用的NLR、降钙素原及C-反应蛋白更高。

Prognostic value of inflammation-based markers in patients with pancreatic cancer administered gemcitabine and erlotinib

AIM: To evaluate the value of systemic inflammationbased markers as prognostic factors for advanced pancreatic cancer(PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio(NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein(CRP)-to-albumin(CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival(PFS) and overall survival(OS). RESULTS: The univariate analysis demonstrated the prognostic value of the NLR(P = 0.049) and the CRP/Alb ratio(P = 0.047) in relation to PFS, and a positiverelationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR(hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients' prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > 5.CONCLUSION: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.

中性粒细胞/淋巴细胞比值、C-反应蛋白/白蛋白及低钙在重症颅脑损伤并早期呼吸机相关性肺炎的价值分析

目的评价中性粒细胞/淋巴细胞比值(NLR)、C-反应蛋白/白蛋白比值(CRP/Alb)及血清钙离子(Ca~(2+))水平在重型颅脑损伤患者(sTBI)并早发型呼吸机性肺炎(EOVAP)的价值。方法选取安徽医科大学第三附属医院ICU 2018年1月至2020年1月符合标准的sTBI患者112例,根据是否并发肺炎分为EOVAP组(40例)和非EOVAP组(72例),比较两组间NLR、CRP/Alb及Ca~(2+)水平差异,采用logistic回归分析及受试者工作特征曲线分析其诊断价值,采用Cox比例风险模型评估以28天时间截点后患者的预后价值。结果根据多因素logistic回归分析显示,外周血NLR、CRP/Alb的显著升高,Alb及Ca~(2+)水平不同程度的降低均为sTBI患者发生EOVAP的独立危险因素(P <0.05)。ROC曲线显示NLR、CRP/Alb诊断sTBI合并EOVAP的AUC为0.814和0.798,明显优于Alb与Ca~(2+)。同时Cox比例风险回归模型评估分析表明:NLR(OR=1.126,95%CI:1.072~1.181,P <0.01)和CRP/Alb(OR=2.652,95%CI:1.203~15.846,P <0.01)是患者28 d预后的危险因素。结论 NLR、CRP/Alb以及低钙血症对预测sTBI患者并发EOVAP有较高的临床诊断价值,同时NLR和CRP/Alb与患者28 d预后密切相关。

肾病综合征患者胆碱酯酶与白蛋白比值临床意义的探讨

目的 探讨血清胆碱酯酶（CHE）与血清白蛋白（ALB）比值检测在肾病综合征患者中的临床应用价值.方法对抚顺市中心医院2013年1～9月54例肾病综合征患者和71例排除肝脏疾病、心脏疾病、外科手术的患者及其他肾脏疾病的体检人员（对照组）进行外周血CHE、ALB检测,同时检测肾病综合征患者尿蛋白.结果肾病综合征患者中CHE、ALB、CHE/ALB比值与对照组组间比较差异有统计学意义（P ＜ 0.05）;CHE/ALB对肾病综合征的诊断阳性率98.1%,并且与患者尿蛋白的量呈正相关（r=0.5687）.结论肾病综合征患者CHE/ALB比值增高可以做为肾病综合征的诊断标准,并反映肾病综合征的病情危重程度.

血清C反应蛋白与白蛋白比值对晚期结直肠癌患者预后的判断价值

目的探讨血清C反应蛋白与白蛋白比值对晚期结直肠癌患者预后的判断价值。方法 64例晚期结直肠癌患者,均进行2年随访,根据患者存活状态分为存活组和死亡组,各32例。比较两组患者初次入院时血清C反应蛋白、白蛋白及血清C反应蛋白/白蛋白比值,分析血清C反应蛋白、白蛋白及血清C反应蛋白/白蛋白比值预测患者生存的ROC曲线。结果初次入院时死亡组血清C反应蛋白、白蛋白、血清C反应蛋白/白蛋白比值分别为(26.35±8.54)mg/L、(26.31±4.58)mg/L、(1.02±0.24),存活组分别为(18.52±7.98)mg/L、(31.58±5.19)mg/L、(0.75±0.36);死亡组初次入院时血清C反应蛋白、血清C反应蛋白/白蛋白比值高于存活组,白蛋白低于存活组,差异有统计学意义(P<0.05)。血清C反应蛋白、白蛋白及血清C反应蛋白/白蛋白比值预测患者生存的ROC曲线存在明显差异,血清C反应蛋白/白蛋白比值的曲线下面积(AUC)明显高于血清C反应蛋白、白蛋白,差异有统计学意义(P<0.05)。结论结直肠癌的发展过程中检测血清C反应蛋白与白蛋白比值可以预测晚期结直肠癌患者预后,值得在临床上扩大样本量进一步研究。

白蛋白与C反应蛋白比值、红细胞分布宽度及血尿酸评估维持性血液透析患者预后的价值

目的探讨白蛋白与C反应蛋白比值(albumin/C-reactive protein,Alb/CRP)、红细胞分布宽度(red blood cell distribution width,RDW)、血尿酸(serum uric acid,SUA)与终末期肾病(end stage renal disease,ESRD)维持性血液透析(maintenance hemodialysis,MHD)患者预后的关系,并分析各指标联合预测预后的价值。方法选取空军军医大学第一附属医院265例ESRD患者,均行MHD治疗,6个月后根据患者生存状况分为死亡组(n=31)、存活组(n=234),比较2组临床资料、Alb/CRP、RDW、SUA水平,分析各指标及联合预测预后的价值。结果265例ESRD患者MHD治疗6个月共有31例死亡,死亡率11.70%;与治疗前相比,2组治疗3个月、5个月后Alb/CRP、SUA均降低,RDW均升高,且死亡组Alb/CRP、SUA低于存活组(F=18.261、20.608,P均<0.001),RDW高于存活组(F=16.256,P<0.001);治疗3个月、5个月后Alb/CRP(OR=0.507,95%CI:0.315~0.817;OR=0.610,95%CI:0.405~0.918)、SUA(OR=0.391,95%CI:1.264~1.417;OR=0.445,95%CI:0.205~0.964)、RDW(OR=1.338,95%CI:1.264~1.417;OR=1.439,95%CI:1.355~1.529)水平变化均为ESRD患者MHD治疗预后的影响因素(P均<0.001);治疗3个月、5个月后Alb/CRP、RDW、SUA预测ESRD患者MHD治疗预后的AUC均>0.7,其中治疗5个月后各指标联合预测预后的AUC最大,为0.890。结论Alb/CRP、RDW、SUA与ESRD患者MHD治疗的预后相关,各指标联合在预测患者预后方面具有较高价值。

Correlation analysis of CRP/ALB and P-CRP in the prognosis of non-small cell lung cancer

Objective:The purpose of this study was to investigate the relationship between preoperative C-reactive protein/albumin ratio(CRP/ALB),platelet count and C-reactive protein product(P-CRP)and clinical prognosis in patients with non-small cell lung cancer.Methods:From January 2015 to December 2015,284 patients who underwent surgery for lung cancer in the First Affiliated Hospital of Bengbu Medical College were selected.According to their 3-year and 5-year survival conditions,ROC curves were drawn and the best cut-off value was determined.According to the cut-off value,the patients were divided into high CRP/ALB group,low CRP/ALB group,high P-CRP group and low P-CRP group.Survival curves were described by Kaplan-Meier method and compared by Log-rank test.The univariate and multivariate analyses were performed with the Cox proportional hazard model to evaluate the prognostic factors.Results:Survival analysis showed that there was no significant difference in 3-year survival rate between high CRP/ALB and P-CRP groups and low CRP/ALB and P-CRP groups,while the 5-year survival rate in high CRP/ALB and P-CRP groups was significantly lower than that in low CRP/ALB and P-CRP groups.Cox proportional hazard model showed that CRP/ALB,age,smoking history,lymph node metastasis and TNM stage were risk factors for 5-year survival rate.Conclusion:as a prognostic index based on inflammation,preoperative CRP/ALB level can better reflect the prognosis of patients than P-CRP.