原发性膝骨关节炎患者C反应蛋白/前白蛋白比值与病情严重性、发病的关系  

Relationship between C-reactive protein/prealbumin ratio and severity of illness and onset in patients with primary knee osteoarthritis

作　　者：王一帆 辛天闻 袁景[1] 汤月平[1] 姚喆 WANG Yifan;XIN Tianwen;YUAN Jing;TANG Yueping;YAO Zhe(Department of Orthopedics,Nanjing Medical University Affiliated Suzhou Hospital,Suzhou,Jiangsu 215000,China)

机构地区：[1]南京医科大学附属苏州医院骨科,江苏苏州215000

出　　处：《国际检验医学杂志》2025年第4期409-413,共5页International Journal of Laboratory Medicine

基　　金：中国博士后科学基金会项目(2023M741792)。

摘　　要：目的探讨原发性膝骨关节炎(KOA)患者C反应蛋白(CRP)/前白蛋白(PAB)比值与病情严重性、发病的关系。方法选取2018年10月至2023年10月该院收治的102例原发性KOA患者作为研究组,另选取该院100例同期体检健康者作为对照组。根据凯尔格伦-劳伦斯(K-L)分级标准将102例原发性KOA患者分为K-LⅠ级组(n=21),K-LⅡ级组(n=27),K-LⅢ级组(n=34),K-LⅣ级组(n=20)。采用全自动生化分析仪检测CRP、PAB水平,计算CRP/PAB比值。采用受试者工作特征曲线分析CRP、PAB及CRP/PAB比值对原发性KOA发病的预测价值,采用多因素Logistic回归分析原发性KOA患者发病的影响因素。结果不同K-L分级原发性KOA患者CRP、PAB及CRP/PAB比值比较,差异有统计学意义(P<0.05)。K-LⅠ级组至K-LⅣ级组原发性KOA患者西安大略和麦克马斯特大学骨关节炎指数(WOMAC)总评分依次为(40.91±5.18)、(46.08±9.21)、(51.24±7.46)、(65.83±12.93)分,差异有统计学意义(P<0.05)。原发性KOA患者CRP、CRP/PAB比值与K-L分级、WOMAC总评分呈正相关(P<0.05),PAB与K-L分级、WOMAC总评分呈负相关(P<0.05)。研究组患者CRP、CRP/PAB比值高于对照组,PAB水平低于对照组,差异有统计学意义(P<0.05)。CRP、PAB水平预测原发性KOA发病的曲线下面积(AUC)及95%CI分别为0.781(0.736~0.831)、0.853(0.781~0.876),CRP/PAB比值预测的AUC为0.937(0.892~0.987)。结论CRP、CRP/PAB比值在原发性KOA患者中呈高表达,PAB在原发性KOA患者中呈低表达,且与患者病情严重性及发病有关,可作为预测原发性KOA患者病情严重性及发病的潜在标记物。Objective To investigate the relationship between the ratio of C-reactive protein(CRP)/prealbumin(PAB)and severity of illness and onset in patients with primary knee osteoarthritis(KOA).Methods A total of 102 patients with primary KOA admitted to a hospital from October 2018 to October 2023 were selected as the study group,and 100 healthy people in a hospital during the same period were selected as the control group.According to the Kelgren-Lawrence(K-L)grading criteria,102 patients with primary KOA were divided into K-L gradeⅠgroup(n=21),K-L gradeⅡgroup(n=27),K-L gradeⅢgroup(n=34),and K-L gradeⅣgroup(n=20).The levels of CRP and PAB were measured by automatic biochemical analyzer,and the ratio of CRP/PAB was calculated.The predictive value of CRP,PAB and CRP/PAB ratio to the incidence of primary KOA was analyzed by receiver operating characteristic curve,and the influencing factors of the incidence of primary KOA patients were analyzed by multivariate Logistic regression.Results There were significant differences in CRP,PAB and CRP/PAB ratio among primary KOA patients with different K-L grades(P<0.05).The total score of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)for primary KOA patients from K-L groupⅠto K-L groupⅣwere(40.91±5.18),(46.08±9.21),(51.24±7.46),(65.83±12.93)points,respectively.The difference was statistically significant(P<0.05).In patients with primary KOA,CRP and CRP/PAB ratio were positively correlated with K-L grade and WOMAC total score,while PAB was negatively correlated with K-L grade and WOMAC total score(P<0.05).CRP and CRP/PAB ratio in study group were higher than those in control group,and PAB level was lower than those in control group,the differences were statistically significant(P<0.05).The area under the curve(AUC)and 95%CI of CRP and PAB levels were 0.781(0.736—0.831)and 0.853(0.781—0.876),respectively,and the AUC of CRP/PAB ratio was 0.937(0.892—0.987).Conclusion CRP and CRP/PAB ratio are highly expressed in patients with primary KOA,an

关 键 词：原发性膝骨关节炎 C反应蛋白/前白蛋白比值 病情严重性 

分 类 号：R684.3[医药卫生—骨科学]