目的 探讨新型炎性反应标志物血清C-反应蛋白/白蛋白(CRP/Alb)比值与类风湿关节炎(rheumatoid arthritis,RA)疾病活动性之间相关性。方法 回顾性收集150例RA患者的人口学资料与实验室检查结果,根据DAS28-ESR分为RA缓解期(DAS28≤3.2)42例和疾病活动期(DAS28>3.2)108例,比较CRP/Alb等炎性反应指标组间差异及其与RA活动度相关性。结果 RA活动期患者中PLR、NLR与CRP/Alb显著高于RA缓解期患者。CRP/Alb与RA疾病活动度DAS28、红细胞沉降率及PLR、NLR之间呈显著正相关性,ROC曲线显示CRP/Alb用于预测RA活动性曲线下面积为0.748,最佳截断值为0.0951,其敏感性为90.5%,特异性为57.1%。结论 CRP/Alb与RA患者疾病活动性显著相关,具有较好的RA活动性诊断预测价值。
Abstract
Objective To explore the correlations between CRP/Alb, a novel inflammatory marker, and disease activity of rheumatoid arthritis. Methods Demographic characteristics and laboratory examination results of 150 patients with RA were retrospectively collected and divided into the remission stage group (DAS28≤3.2, n=42) and the active stage group (DAS28>3.2, n=108) according to their DAS28-ESR. The difference in CRP/Alb and other inflammatory markers between the two groups and the correlations with RA disease activity were analyzed. Results Levels of PLR, NLR and CRP/Alb in RA patients in the active stage were significantly higher than those of patients in the remission stage. CRP/Alb was positively correlated with RA disease activity involving DAS28, ESR, PLR and NLR. The ROC curve showed that the area under the curve of CRP/Alb for predicting RA disease activity was 0.748, and the best cutoff value was 0.0951, with a sensitivity of 90.5% and a specificity of 57.1%. Conclusions CRP/Alb is significantly correlated with disease activity of RA patients, which is of good diagnostic and predictive value for RA disease activity.
关键词
类风湿关节炎 /
疾病活动性评分 /
血小板/淋巴细胞比值 /
中性粒/淋巴细胞比值 /
C-反应蛋白/白蛋白比值
Key words
rheumatoid arthritis /
disease activity score /
platelet/lymphocyte ratio /
neutrophil/lymphocyte ratio /
c-reactive protein/albumin ratio
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参考文献
[1] Scott D L, Wolfe F, Huizinga T W. Rheumatoid arthritis [J].Lancet, 2010,376(9746):1094-1108.
[2] He Y, Tang J, Wu B, et al. Correlation between albumin to fibrinogen ratio, C-reactive protein to albumin ratio and Th17 cells in patients with rheumatoid arthritis [J].Clin Chim Acta, 2020,500:149-154.
[3] Yang W M, Zhang W H, Ying H Q, et al. Two new inflammatory markers associated with disease activity score-28 in patients with rheumatoid arthritis: albumin to fibrinogen ratio and C-reactive protein to albumin ratio [J].Int Immunopharmacol, 2018,62:293-298.
[4] Schwartz P B, Poultsides G, Roggin K, et al. PLR and NLR are poor predictors of survival outcomes in sarcomas: a new perspective from the USSC [J].J Surg Res, 2020,251:228-238.
[5] Diem S, Schmid S, Krapf M, et al. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab [J].Lung Cancer, 2017,111:176-181.
[6] Akboga M K, Canpolat U, Yayla C, et al. Association of platelet to lymphocyte ratio with inflammation and severity of coronary atherosclerosis in patients with stable coronary artery disease [J].Angiology, 2016,67(1):89-95.
[7] Bao X, Zhou G Z, Xu W, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio: novel markers for the diagnosis and prognosis in patients with restenosis following CAS [J].Biomark Med, 2020,14(4):271-282.
[8] Sunbul M, Gerin F, Durmus E, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension [J].Clin Exp Hypertens, 2014,36(4):217-221.
[9] Gasparyan A Y, Ayvazyan L, Mukanova U, et al. The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases [J].Ann Lab Med, 2019,39(4):345-357.
[10] Wei X L, Wang F H, Zhang D S, et al. A novel inflammation-based prognostic score in esophageal squamous cell carcinoma: the C-reactive protein/albumin ratio [J].BMC Cancer, 2015,15:350.
[11] Van Riel P L, Renskers L. The disease activity score (DAS) and the disease activity score using 28 joint counts (DAS28) in the management of rheumatoid arthritis [J].Clin Exp Rheumatol, 2016,34(5 Suppl 101):s40-s44.
[12] Du J, Chen S, Shi J, et al. The association between the lymphocyte-monocyte ratio and disease activity in rheumatoid arthritis [J].Clin Rheumatol, 2017,36(12):2689-2695.
[13] Dans L F, Tankeh-Torres S, Amante C M,et al. The prevalence of rheumatic diseases in a Filipino urban population: a WHO-ILAR COPCORD Study. World Health Organization. International league of associations for rheumatology. Community oriented programme for the control of the rheumatic diseases[J].J Rheumatol, 1997,24(9): 1814-1819.
[14] Remalante P M, Salido E O, Penserga E G, et al. Red cell distribution width and neutrophil-lymphocyte ratio in rheumatoid arthritis [J].Rheumatol Int, 2020,40(10): 1631-1637
[15] Uslu A U, Küçük A, Şahin A, et al. Two new inflammatory markers associated with disease activity score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio [J].Int J Rheum Dis, 2015,18(7): 731-735.
[16] Sproston N R, Ashworth J J. Role of C-reactive protein at sites of inflammation and infection [J].Front Immunol, 2018,9:754.
[17] Arroyo V, García-Martinez R, Salvatella X. Human serum albumin, systemic inflammation, and cirrhosis [J].J Hepatol, 2014,61(2):396-407.
[18] Eckart A, Struja T, Kutz A, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: a prospective study [J].Am J Med, 2020,133(6):713-722.
[19] Don B R, Kaysen G. Serum albumin: relationship to inflammation and nutrition [J]. Semin Dial, 2004,17(6):432-437.
[20] Ding R, Li P, Song D, et al. Predictors of response to TNF-α antagonist therapy in Chinese rheumatoid arthritis [J].Clin Rheumatol, 2015,34(7):1203-1210.
[21] Ogata A, Kato Y, Higa S, et al. IL-6 inhibitor for the treatment of rheumatoid arthritis: a comprehensive review [J].Mod Rheumatol, 2019,29(2):258-267.
[22] Orr C K, Najm A, Young F, et al. The utility and limitations of CRP, ESR and DAS28-CRP in appraising disease activity in rheumatoid arthritis [J].Front Med, 2018,5: 185.
[23] Afifi N, B M M, Abdel Ghani A M, et al. Value of albumin-fibrinogen ratio and CRP-albumin ratio as predictor marker of disease activity in Egyptian RA patients, correlated with musculoskeletal sonography [J].Open Access Rheumatol, 2020,12: 241-248.
基金
国家自然科学基金项目资助(81273878) 陕西省重点研发计划项目资助(2021SF-321)
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