血清学比值指标评估溃疡性结肠炎内镜下严重程度的临床价值  

CLINICAL VALUE OF SEROLOGICAL RATIOS IN EVALUATING THE ENDOSCOPIC SEVERITY OF ULCERATIVE COLITIS

作　　者：闫静 武军[1] 张晓静[1] 刘爱玲[1] 徐楠[2] 徐永红[1] YAN Jing;WU Jun;ZHANG Xiaojing;LIU Ailing;XU Nan;XU Yonghong(Department of Gastroenterology,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院消化内科,山东青岛266003 [2]大连医科大学附属第一医院麻醉科

出　　处：《青岛大学学报（医学版）》2023年第5期725-729,共5页Journal of Qingdao University(Medical Sciences)

基　　金：山东省自然科学基金青年科学基金项目(Z-R2020QH031)。

摘　　要：目的探讨纤维蛋白原(FIB)/清蛋白(ALB)、FIB/总胆红素(TBIL)、FIB/间接胆红素(IBIL)、C反应蛋白(CRP)/ALB、CRP/TBIL及CRP/IBIL等比值指标评估溃疡性结肠炎(UC)内镜下严重程度的临床价值。方法回顾性分析123例UC病人的临床、实验室及内镜学资料。以内镜Mayo评分作为分组标准,分为内镜缓解组(n=32)、中度活动组(n=51)及重度活动组(n=40),分析3组间各血清学指标的差异及其与内镜下疾病活动度的相关性,并绘制受试者工作特征(ROC)曲线,评估各指标预测中重度UC的诊断效能。结果内镜缓解组、中度活动组及重度活动组病人的年龄及病变部位差异有统计学意义(H=12.36,χ^(2)=56.81,P<0.01)。3组间各血清学指标差异有统计学意义(H=20.70~40.78,P<0.001),其中,重度活动组的FIB/ALB、FIB/TBIL、FIB/IBIL、CRP/ALB、CRP/TBIL、CRP/IBIL及FIB水平显著高于中度活动组和内镜缓解组,中度活动组亦高于内镜缓解组(Z=20.62~53.97,P<0.05);且上述各指标与UC内镜下活动度呈正相关关系(r=0.494~0.577,P<0.001)。而重度活动组及中度活动组的血清TBIL、IBIL均低于内镜缓解组(Z=21.17~41.28,P<0.05),且两指标与UC内镜下活动度呈负相关关系(r=-0.437~-0.417,P<0.001)。ROC曲线分析显示,CRP/TBIL、CRP/IBIL是血清学比值指标中评估UC内镜下中重度活动效能最优的指标,其曲线下面积分别为0.824和0.816。结论血清学比值指标在评价UC内镜下中重度病变方面表现良好,CRP/TBIL及CRP/IBIL是效能最优的指标。Objective To investigate the clinical value of fibrinogen(FIB)/albumin(ALB)ratio,FIB/total bilirubin(TBIL)ratio,FIB/indirect bilirubin(IBIL)ratio,C-reactive protein(CRP)/ALB ratio,CRP/TBIL ratio,and CRP/IBIL ratio in assessing the endoscopic severity of ulcerative colitis(UC).Methods A retrospective analysis was performed for the clinical,laboratory,and endoscopic data of 123 patients with UC.According to the endoscopic Mayo score,the patients were divided into endoscopic remissiongroup with 32 patients,moderate activity group with 51 patients,and severe activity group with 40 patients.The three groups were compared in terms of each serological index and theircorrelation with endoscopic disease activity,and the receiver operating characteristic(ROC)curve was plotted to investigate the diagnostic efficiency of each index in predicting moderate-to-severe UC.Results There were significant differences in age and location of lesionbetween the endoscopic remission group,the moderateactivity group,and the severe activity group(H=12.36,χ2=56.81,P<0.01).There were significant differences in each serological index between the three groups(H=20.70-40.78,P<0.001);the severe activity group had significantly higher levels of FIB/ALB,FIB/TBIL,FIB/IBIL,CRP/ALB,CRP/TBIL,CRP/IBIL,and FIB than themoderate activity groupand theendoscopic remission group,and the moderate activity group also had significantly higher levels of these indices than theendoscopicremission group(Z=20.62-53.97,P<0.05);moreover,the above indiceswere positively correlated with the endoscopic activity of UC(r=0.494-0.577,P<0.001).The severe activity group and the moderate activity group had significantly lower serum levels of TBIL and IBIL than the endoscopicremission group(Z=21.17-41.28,P<0.05),and these two indices were negatively correlated with the endoscopic activity of UC(r=-0.437 to-0.417,P<0.001).The ROC curve analysis showed that CRP/TBIL and CRP/IBIL ratios were the optimal indices for the assessment of moderate-to-severe lesions in UC under endoscop

关 键 词：结肠炎 溃疡性 结肠镜检查 临床实验室技术 疾病严重程度指数 

分 类 号：R574.62[医药卫生—消化系统]