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C 反应蛋白/白蛋白比值作为 Behçet 病和人类白细胞抗原-B27 相关葡萄膜炎疾病活动的指标。

C-reactive protein/albumin ratio as an indicator of disease activity in Behçet's disease and human leukocyte antigen-B27-associated uveitis.

机构信息

Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea.

Catholic Institute for Visual Science, College of Medicine, Catholic University of Korea, Seoul, Korea.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1985-1992. doi: 10.1007/s00417-021-05207-y. Epub 2021 Apr 30.

Abstract

PURPOSE

To explore the role of systemic inflammatory markers as indicators of acute exacerbation of chronic diseases and disease activity in uveitis.

METHODS

This study included 50 patients with Behçet's disease (BD)-associated uveitis and 52 patients with human leukocyte antigen-B27 (HLA-B27)-associated uveitis. Laboratory tests were conducted to measure complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), CRP/albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) during the uveitis phase and after resolution. The results measured during the two phases were assessed and compared.

RESULTS

The mean age of the participants was 41.4 ± 10.8 years; 68.6% of the patients were male. In both groups, ESR, CRP, and CAR were significantly higher during the uveitic phase (P < .001). However, the white blood cell count, albumin, NLR, and PLR measured during the uveitic phase and after resolution did not vary significantly (P > .05). ESR and CAR were correlated with the severity of intraocular inflammation. The area under the curve (AUC) of CAR, which was used to predict the presence of uveitis, was 0.801 (95% CI, 0.741-0.861); this value is strong compared with those of other inflammatory biomarkers.

CONCLUSIONS

CAR is correlated with the severity of intraocular inflammation in BD- and HLA-B27-associated uveitis. Furthermore, CAR appears to be a useful marker of disease activity for uveitis and is the most sensitive marker for discriminating the presence of acute uveitis in patients who have chronic uveitis as a symptom of BD- and HLA-B27-associated diseases.

摘要

目的

探讨系统性炎症标志物在葡萄膜炎急慢性发作和疾病活动中的作用。

方法

本研究纳入 50 例 Behçet 病(BD)相关性葡萄膜炎患者和 52 例人类白细胞抗原-B27(HLA-B27)相关性葡萄膜炎患者。在葡萄膜炎期和缓解后,进行实验室检查以测量全血细胞计数、红细胞沉降率(ESR)、C 反应蛋白(CRP)、CRP/白蛋白比值(CAR)、中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)。评估并比较两个阶段的测量结果。

结果

参与者的平均年龄为 41.4±10.8 岁;68.6%的患者为男性。在两组中,ESR、CRP 和 CAR 在葡萄膜炎期均显著升高(P<0.001)。然而,在葡萄膜炎期和缓解后测量的白细胞计数、白蛋白、NLR 和 PLR 无显著差异(P>0.05)。ESR 和 CAR 与眼内炎症的严重程度相关。用于预测葡萄膜炎存在的 CAR 的曲线下面积(AUC)为 0.801(95%CI,0.741-0.861);与其他炎症生物标志物相比,该值较高。

结论

CAR 与 BD 和 HLA-B27 相关性葡萄膜炎的眼内炎症严重程度相关。此外,CAR 似乎是葡萄膜炎疾病活动的有用标志物,并且是区分慢性葡萄膜炎患者急性葡萄膜炎存在的最敏感标志物,慢性葡萄膜炎是 BD 和 HLA-B27 相关性疾病的症状之一。

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