Departamento de Medicina Interna, Facultad de Medicina, Universidad de Alejandría, Egypt.
Departamento de Patología Clínica, Facultad de Medicina, Universidad de Alejandría, Egypt.
Rev Gastroenterol Mex (Engl Ed). 2022 Oct-Dec;87(4):447-454. doi: 10.1016/j.rgmxen.2022.06.007. Epub 2022 Jul 7.
The C-reactive protein/albumin ratio (CAR) is an inflammatory marker that is considered to have prognostic value in many diseases. Our aim in the present study was to investigate the diagnostic performance of the CAR in determining the clinical severity of acute severe ulcerative colitis (ASUC).
A retrospective study on 200 UC patients that were admitted to the Gastroenterology unit of the Alexandria University, over an 8-year period from January 2012 to January 2020, was conducted. Patient demographic data, laboratory values, and clinical and endoscopic disease activity scores were evaluated. C-reactive protein (CRP) and albumin levels were recorded. The CAR was calculated to determine clinical severity.
Of the 200 patients, 135 (67.5%) were men and 65 (32.5%) were women. Mean age was 43.5 ± 9.8 years. Patients were divided into groups with mild, moderate, or severe disease activity and there were statistically significant differences in the CAR, the erythrocyte sedimentation rate (ESR), CRP levels, and albumin levels (p = 0.001; p < 0.05). With a cut-off value of 0.6, the CAR performed best in defining patients with severe disease, with an area under the curve (AUC) of 0.985, 98% sensitivity, 100% specificity, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 97%, p < 0.001. AUC values for the diagnosis of severe disease were 0.985, 0.88, 0.72, and 0.65 for the CAR, CRP, albumin, and the ESR, respectively.
There was a statistically significant association between the CAR and clinical disease activity in patients with UC. The CAR is a reliable and practical tool for detecting ASUC.
C 反应蛋白/白蛋白比值（CAR）是一种炎症标志物，被认为在许多疾病中有预后价值。本研究旨在探讨 CAR 在确定急性重度溃疡性结肠炎（ASUC）临床严重程度中的诊断性能。
对 200 例在 2012 年 1 月至 2020 年 1 月期间在亚历山大大学胃肠病科住院的 UC 患者进行回顾性研究。评估患者的人口统计学数据、实验室值、临床和内镜疾病活动评分。记录 C 反应蛋白（CRP）和白蛋白水平。计算 CAR 以确定临床严重程度。
200 例患者中，男性 135 例（67.5%），女性 65 例（32.5%）。平均年龄为 43.5±9.8 岁。患者分为疾病活动度轻、中、重度组，CAR、红细胞沉降率（ESR）、CRP 水平和白蛋白水平差异有统计学意义（p=0.001；p<0.05）。CAR 的截断值为 0.6，对定义重度疾病的患者最佳，曲线下面积（AUC）为 0.985，敏感性 98%，特异性 100%，阳性预测值（PPV）为 100%，阴性预测值（NPV）为 97%，p<0.001。CAR、CRP、白蛋白和 ESR 对重度疾病的诊断 AUC 值分别为 0.985、0.88、0.72 和 0.65。
CAR 与 UC 患者的临床疾病活动度有统计学显著关联。CAR 是一种可靠且实用的工具，可用于检测 ASUC。
