Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2021 Apr 9;100(14):e25200. doi: 10.1097/MD.0000000000025200.
Persistent disease activity is associated with a poor prognosis in patients with inflammatory bowel disease (IBD). This study aims to explore the accuracy of the highly sensitive C-reactive protein/albumin ratio (CAR) in determining IBD activity.The clinical data of 231 IBD patients treated at Peking Union Medical College Hospital from 2012 to 2018 were analyzed retrospectively. The patients were classified as having active disease or remission according to the Crohn disease activity index scores for patients with Crohn disease (CD) and partial Mayo scores for patients with ulcerative colitis (UC).This study included 231 IBD patients (137 CD and 94 UC). From these groups, 182 patients had active disease, while 49 patients were in remission. The platelet counts, erythrocyte sedimentation rates, high-sensitivity C-reactive protein levels, and CAR scores were significantly higher, while hemoglobin levels, ALB, and body mass indexes were significantly lower in patients with active disease (P < 0.01). The hsCRP, CAR, and ALB significantly correlated with disease activity for both CD and UC (P < 0.001). The area under the curve (AUC) of CAR was highest among the laboratory indexes at 0.829, and the AUC of CAR in the UC patients was larger than that of the CD patients. Also, CAR with cutoff value of 0.06 displayed the highest sensitivity among the indexes for IBD activity at 83.05%.CAR is a useful biomarker for identifying disease activity in patients with CD and UC. Higher CAR levels are indicative of increased IBD activity. CAR may be more valuable in UC than that in CD for assessing the degree of IBD activity.
持续性疾病活动与炎症性肠病（IBD）患者的不良预后相关。本研究旨在探讨高敏 C 反应蛋白/白蛋白比值（CAR）在确定 IBD 活动度方面的准确性。
回顾性分析了 2012 年至 2018 年北京协和医院收治的 231 例 IBD 患者的临床资料。根据克罗恩病患者的克罗恩病活动指数评分（CD）和溃疡性结肠炎患者的部分 Mayo 评分，将患者分为活动期或缓解期。
本研究纳入 231 例 IBD 患者（137 例 CD 和 94 例 UC）。其中，182 例患者为活动期，49 例为缓解期。活动期患者的血小板计数、红细胞沉降率、高敏 C 反应蛋白水平和 CAR 评分显著升高，血红蛋白水平、ALB 和体重指数显著降低（P<0.01）。hsCRP、CAR 和 ALB 与 CD 和 UC 的疾病活动均显著相关（P<0.001）。在实验室指标中，CAR 的曲线下面积（AUC）最高为 0.829，UC 患者的 CAR AUC 大于 CD 患者。此外，CAR 的截断值为 0.06 时，对 IBD 活动的敏感度最高，为 83.05%。
CAR 是识别 CD 和 UC 患者疾病活动的有用生物标志物。CAR 水平越高，IBD 活动度越高。CAR 可能比 CD 更能评估 UC 患者的 IBD 活动程度。
