The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, Xinjiang, China.
Department of Pathophysiology, College of Basic Medical, Xinjiang Medical University, Urumqi, 830011, China.
BMC Gastroenterol. 2022 Dec 26;22(1):540. doi: 10.1186/s12876-022-02634-x.
At present, many indicators reflect the clinical disease activity of ulcerative colitis (UC). However, commonly used inflammatory markers do not show good utility for indicating endoscopic disease activity. The purpose of this study was to evaluate high sensitivity C-reactive protein (hs-CRP), C-reactive protein to albumin ratio (CAR), inflammatory markers, and complete blood count (CBC) related parameters in patients with UC as simple, non-invasive, and independent markers of endoscopic activity (EA).
We retrospectively collected extensive data from the hospital medical records of 386 patients who presented with UC to the First Affiliated Hospital of Xinjiang Medical University (Urumqi, China) from 2018 to 2022 January. The Mayo endoscopic score (MES) was used to evaluate endoscopic disease activity. All included patients were defined as the MES-All group; those with extensive colitis (E3) were defined as the MES-E3 group. Demographics, laboratory parameters, endoscopic results, the extent of disease, and drug history were recorded and analyzed.
For patients in the MES-All or MES-E3 group, hs-CRP, CAR, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) were significantly higher in EA UC patients than in those with mucosal healing. The mean platelet volume (MPV) and lymphocyte to monocyte ratio were significantly lower in active disease than in the patient's remission (p < 0.001). ROC analysis showed that in the MES-All and MES-E3 groups, the cutoff values of hs-CRP activity under endoscopy were 5.32 mg/L (AUC 0.850, sensitivity 77.6%, specificity 81.9%) and 5.16 mg/L (AUC 0.902, sensitivity 86.9%, specificity 85.4%) respectively, and the cutoff values of CAR were 0.14 (AUC 0.853, sensitivity 76.8%, specificity 84.8%) and 0.18 (AUC 0.904, sensitivity 81.8%, specificity 89.6%) respectively. Multivariate logistic regression analysis showed that hs-CRP, CAR, NLR, and PLR identified UC EA, while decreased MPV reflected inflammatory activity in the UC mucosa.
Especially in patients with extensive colitis, hs-CRP and CAR are closely related to EA and show a higher diagnostic value compared to the related CBC parameters. The aforementioned indicators are simple and non-invasive independent markers that reflect the EA in UC.
目前，许多指标反映溃疡性结肠炎（UC）的临床疾病活动度。然而，常用的炎症标志物并不能很好地表明内镜疾病活动度。本研究旨在评估高敏 C 反应蛋白（hs-CRP）、C 反应蛋白与白蛋白比值（CAR）、炎症标志物和全血细胞计数（CBC）相关参数在 UC 患者中作为内镜活动度（EA）的简单、非侵入性和独立标志物。
我们回顾性地从 2018 年至 2022 年 1 月新疆医科大学第一附属医院就诊的 386 例 UC 患者的医院病历中收集了广泛的数据。采用 Mayo 内镜评分（MES）评估内镜疾病活动度。所有纳入患者均定义为 MES-All 组；广泛结肠炎（E3）患者定义为 MES-E3 组。记录并分析人口统计学、实验室参数、内镜结果、疾病程度和药物史。
对于 MES-All 或 MES-E3 组的患者，EAUC 患者的 hs-CRP、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）明显高于黏膜愈合患者。活动期患者的平均血小板体积（MPV）和淋巴细胞与单核细胞比值明显低于缓解期（p<0.001）。ROC 分析显示，在 MES-All 和 MES-E3 组中，hs-CRP 活动度的截断值为 5.32mg/L（AUC 0.850，敏感性 77.6%，特异性 81.9%）和 5.16mg/L（AUC 0.902，敏感性 86.9%，特异性 85.4%），CAR 的截断值分别为 0.14（AUC 0.853，敏感性 76.8%，特异性 84.8%）和 0.18（AUC 0.904，敏感性 81.8%，特异性 89.6%）。多变量逻辑回归分析显示，hs-CRP、CAR、NLR 和 PLR 可识别 UC EA，而 MPV 降低反映了 UC 黏膜的炎症活动。
特别是在广泛结肠炎患者中，hs-CRP 和 CAR 与 EA 密切相关，与相关 CBC 参数相比具有更高的诊断价值。上述指标是简单、非侵入性的独立标志物，可反映 UC 的 EA。
