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[结直肠手术患者C反应蛋白与白蛋白比值与术后并发症的相关性]

[The correlations between C-reactive protein to albumin ratio and postoperative complications in patients with colorectal surgery].

作者信息

Xu M Y, Li Y, Wang Y L, Yang J, Liu Q, Wang Q Y, Wen W, Wang C X

机构信息

Department of General Surgery, Hainan Hospital of People's Liberation Army General Hospital, Sanya 570013, China.

Department of Ophthalmology and Otorhinolaryngology, the 984th Hospital of People's Liberation Army, Beijing 100094, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2021 Feb 1;59(2):144-148. doi: 10.3760/cma.j.cn112139-20200115-00030.

Abstract

To examine the correlations of C-reactive protein (CRP)/albumin ratio (CAR) with the postoperative complications of patients with colorectal cancer. The clinic data of 312 patients undergoing elective surgery for colorectal cancer in Hainan Hospital of People's Liberation Army General Hospital between January 2013 and July 2018 was analyzed retrospectively. There were 188 males and 124 females, aged (61.0±12.9) years (range: 21 to 86 years). Logistic analysis was used to identify relative factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and compare diagnostic accuracy of the CAR and CRP levels. Postoperative complications occured in 28.5% (89/312) cases. Hemoglobin on postoperative day(POD) 3 (=0.977, 95% : 0.957 to 0.998, =0.034), preoperative CRP (=1.209, 95% : 1.055 to 1.386, =0.006) and CAR on POD 3 (=0.033, 95% : 0.016 to 0.067, <0.01) were found to be significant independent relative factors for postoperative complications. The cutoff point of CAR on POD 3 was 0.325, patients with CAR≥0.325 were found to have more postoperative complications than those with CAR<0.325. The area under the curve of CAR on POD 3 and preoperative CRP were 0.872, 0.626, respectively. The positive predictive value of CAR on POD 3 was higher than that of preoperative CRP (79.9% . 55.1%). CAR is closely related to the occurrence of postoperative complications in colorectal surgery. Patients with CAR≥0.325 on POD 3 has higher incidence of postoperative complications.

摘要

探讨C反应蛋白(CRP)/白蛋白比值(CAR)与结直肠癌患者术后并发症的相关性。回顾性分析2013年1月至2018年7月在解放军总医院海南医院接受择期结直肠癌手术的312例患者的临床资料。其中男性188例,女性124例,年龄(61.0±12.9)岁(范围:21至86岁)。采用Logistic分析确定术后并发症的相关因素。绘制受试者工作特征曲线以检查临界值,并比较CAR和CRP水平的诊断准确性。术后并发症发生率为28.5%(89/312)。术后第3天血红蛋白(=0.977,95%可信区间:0.957至0.998,=0.034)、术前CRP(=1.209,95%可信区间:1.055至1.386,=0.006)以及术后第3天的CAR(=0.033,95%可信区间:0.016至0.067,<0.01)被发现是术后并发症的显著独立相关因素。术后第3天CAR的临界值为0.325,发现CAR≥0.325的患者比CAR<0.325的患者术后并发症更多。术后第3天CAR和术前CRP的曲线下面积分别为0.872、0.626。术后第3天CAR的阳性预测值高于术前CRP(79.9%对55.1%)。CAR与结直肠癌手术术后并发症的发生密切相关。术后第3天CAR≥0.325的患者术后并发症发生率更高。

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