外周血NLR和粪便CP、CHI3L1对溃疡性结肠炎患者治疗后内镜下表现进展的预测价值  

Prognostic value of peripheral blood NLR and fecal CP,CHI3L1 in endoscopic findings progression after treatment of patients with ulcerative colitis

作　　者：匡哲 郭慧丽 庞敏 KUANG Zhe;GUO Huili;PANG Min(Department of Gastroenterology,Beijing Pinggu Hospital,Beijing 101200,China)

机构地区：[1]北京平谷区医院消化内科,北京101200

出　　处：《检验医学与临床》2024年第17期2547-2552,共6页Laboratory Medicine and Clinic

基　　金：北京市平谷区卫生健康委科研项目(pgwjw2020-6)。

摘　　要：目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)和粪便钙卫蛋白(CP)、几丁质酶3样蛋白1(CHI3L1)对溃疡性结肠炎(UC)患者治疗后内镜下表现进展的预测价值。方法选择该院2018年1月至2022年10月收治的542例UC患者作为研究对象,治疗前后对所有患者进行内镜评估,根据治疗后UC内镜下严重度指数(UCEIS)评分是否高于治疗前进行分组,其中治疗后UCEIS评分高于治疗前设为进展组,不高于治疗前设为非进展组。比较两组基线资料。使用二元Logistic回归分析UC患者治疗后内镜下表现进展的危险因素。采用受试者工作特征(ROC)曲线评估外周血NLR和粪便CP、CHI3L1对UC患者治疗后内镜下表现进展的预测价值。结果542例UC患者经1年治疗后有83例患者出现了内镜下表现进展,纳入进展组,459例患者未进展,纳入非进展组。进展组治疗后UCEIS评分明显高于治疗前,非进展组治疗后UCEIS评分明显低于治疗前,进展组治疗后UCEIS评分明显高于非进展组,差异均有统计学意义(P<0.05)。进展组病程明显长于非进展组,外周血白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(NEU)、NLR及粪便CP、CHI3L1和血清C反应蛋白(CRP)水平明显高于非进展组,差异均有统计学意义(P<0.05)。二元Logistic回归分析结果显示,校正病程、WBC、PLT、NEU等混杂因素后,外周血NLR和粪便CP、CHI3L1及血清CRP水平升高是UC患者治疗后内镜下表现进展的独立危险因素(P<0.05)。ROC曲线分析结果显示,外周血NLR、粪便CP、粪便CHI3L1预测UC患者治疗后内镜下表现进展的最佳截断值分别为3.12、234.61μg/g、53.75 ng/mL,曲线下面积(AUC)分别为0.819(95%CI:0.768~0.870)、0.762(95%CI:0.706~0.817)、0.724(95%CI:0.666~0.783)。3项指标联合检测预测UC患者治疗后内镜下表现进展的灵敏度为81.93%,特异度为88.45%,AUC为0.920(95%CI:0.890~0.950)。3项指标联合检测的AUC明显大于各项指标单独检测�Objective To investigate the predictive value of peripheral neutrophil to lymphocyte ratio(NLR),fecal calprotectin(CP)and chitinase 3-like protein-1(CHI3L1)in endoscopic findings progression after treatment of patients with ulcerative colitis(UC).Methods A total of 542 patients with UC admitted to Beijing Pinggu Hospital from January 2018 to October 2022 were selected as study subjects.All patients were evaluated by endoscopy before and after treatment,and divided into progressive group and non-progressive group according to whether the UC Endoscopic Severity Index(UCEIS)score after treatment was higher than that before treatment.In the progressive group,the UCEIS score after treatment was higher than that before treatment,patients whose UCEIS score after treatment was not higher than before treatment was classified as non-progressive group.Baseline data of the two groups were compared.A binary Logistic regression model was used to analyze the risk factors for endoscopic progression after UC treatment of patients with UC.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of peripheral blood NLR,fecal CP and CHI3L1 for endoscopic findings progression after UC treatment.Results After 1 year of treatment,83 of 542 UC patients showed progress under endoscopy,who were classified as progressive group,and 459 patients did not,who were classified as non-progressive group.The UCEIS score after treatment in the progressive group was significantly higher than before treatment,the UCEIS score after treatment in the non-progressive group was significantly lower than that before treatment,and the UCEIS score after treatment in the progressive group was significantly higher than that in the non-progressive group,and the differences were significant(P<0.05).The disease course in progressive group was longer than that in the non-progressive group,the peripheral blood white blood cell count(WBC),platelet count(PLT),neutrophil count(NEU),NLR,fecal CP and CHI3L1,serum C-reactive protein(CRP)levels

关 键 词：中性粒细胞与淋巴细胞比值 钙卫蛋白 几丁质酶3样蛋白1 溃疡性结肠炎 内镜检查 

分 类 号：R446.6[医药卫生—诊断学] R574.63[医药卫生—临床医学]