Huang Xijing, Pan Yan, Liu Ya, Zhou Zhou, Zhang Yinghui, Gao Caiping, He Chong
Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
J Inflamm Res. 2023 Jun 16;16:2549-2559. doi: 10.2147/JIR.S413644. eCollection 2023.
Ulcerative colitis (UC) is a chronic relapsing remitting form of inflammatory bowel disease (IBD). Current disease monitoring includes evaluation of symptoms, fecal calprotectin, and colonoscopy. Due to limited availability of the latter two modalities in China, we sought a readily available, inexpensive, disease monitoring laboratory assessment. We recently identified a novel serological index (the neutrophil-to-bilirubin ratio, NBR) for monitoring disease activity in Crohn's disease. However, the clinical significance has not been evaluated in UC. Here, we aimed to verify the hypothesis that NBR might be useful in monitoring clinical and endoscopic activity in patients with UC.
To test our hypothesis, we conducted a single-center, retrospective study including a total of 188 patients with UC and 145 non-IBD controls. NBR was calculated to determine its practical value in monitoring disease activity (including clinical and endoscopic activity). Disease activity of UC was determined by the partial Mayo score and the Mayo endoscopic score (MES) system.
NBR was significantly higher in patients with UC than that in controls (12.10, IQR: 9.85-16.69 versus 5.06, IQR: 3.94-6.55; p < 0.001) and showed positive correlations with clinical and endoscopic disease activity in UC. Additionally, NBR was significantly lower in patients with endoscopic mucosal healing (MH) than that in those without endoscopic MH (8.81, IQR: 6.67-11.67 versus 13.51, IQR: 11.04-18.71; p < 0.001). Serial evaluation of NBR in a subset of patients demonstrated that NBR was significantly decreased during the MH stage compared with that during the endoscopically active stage.
Our study suggests that NBR may be a promising candidate for assessing disease activity in UC, with potential for widespread clinical use and significant clinical implications.
溃疡性结肠炎（UC）是炎症性肠病（IBD）的一种慢性复发缓解型疾病。目前的疾病监测包括症状评估、粪便钙卫蛋白检测和结肠镜检查。由于后两种检查在中国的可及性有限，我们寻求一种易于获得且成本低廉的疾病监测实验室评估方法。我们最近发现了一种用于监测克罗恩病疾病活动的新型血清学指标（中性粒细胞与胆红素比值，NBR）。然而，其在UC中的临床意义尚未得到评估。在此，我们旨在验证NBR可能有助于监测UC患者临床和内镜下疾病活动的这一假设。
为验证我们的假设，我们进行了一项单中心回顾性研究，共纳入188例UC患者和145例非IBD对照者。计算NBR以确定其在监测疾病活动（包括临床和内镜下活动）方面的实用价值。UC的疾病活动通过部分梅奥评分和梅奥内镜评分（MES）系统来确定。
UC患者的NBR显著高于对照组（12.10，四分位数间距：9.85 - 16.69，而对照组为5.06，四分位数间距：3.94 - 6.55；p < 0.001），并且与UC的临床和内镜下疾病活动呈正相关。此外，内镜下黏膜愈合（MH）患者的NBR显著低于未实现内镜下MH的患者（8.81，四分位数间距：6.67 - 11.67，而未愈合者为13.51，四分位数间距：11.04 - 18.71；p < 0.001）。对一部分患者进行NBR的连续评估表明，与内镜活动期相比，MH期的NBR显著降低。
我们的研究表明，NBR可能是评估UC疾病活动的一个有前景的指标，具有广泛临床应用的潜力和重要的临床意义。
