摘要
目的:分析血小板参数和预后营养指数(PNI)在溃疡性结肠炎(UC)活动度中的预测价值。方法:这项回顾性研究纳入了2020年1月至2022年6月期间来自湖南中医药大学第一附属医院肛肠科的158名UC病人。使用Mayo总分、Truelove-Witts评分评估临床活动度。Mayo评分>2的病人定义为临床活动期UC,Mayo评分≤2的病人定义为临床缓解期。通过Riley评分评估组织学活性。通过Mayo内窥镜评分评估UC病人的内窥镜活动度。结果:在纳入分析的158名病人中,111例为缓解期,其余47例为临床活动期。与缓解期组相比,临床活动期组的白蛋白、淋巴细胞、PNI水平显著降低(P<0.05),CRP、粪便钙卫蛋白、中性粒细胞、白细胞、NPR、NLR水平显著增加(P<0.05)。粪便钙卫蛋白、CRP、NPR、NLR与Mayo内窥镜评分、Riley评分、Truelove Witts评分、Mayo总分呈显著正相关性(P<0.05),PNI与Mayo内窥镜评分、Truelove Witts评分、Mayo总分呈显著负相关性(P<0.05)。粪便钙卫蛋白、NPR预测UC病人临床活动度的性能接近(AUC=0.868、0.850),其次为PNI(AUC=0.770)、NLR(AUC=0.756);粪便钙卫蛋白预测UC病人内窥镜活动度的性能最大(AUC=0.840),其次为NPR(AUC=0.731)、NLR(AUC=0.677)、PNI(AUC=0.671)。结论:NPR在识别具有临床和内窥镜检查活动的UC病人显示了一定的诊断效用,并与粪便生物标志物钙卫蛋白的诊断性能接近。PNI作为UC疾病活动度监测工具的性能较低。
Objective:To analyze the predictive value of platelet parameters and prognostic nutritional index(PNI)in activity of ulcerative colitis(UC).Methods:This retrospective study included 158 UC patients from the Department of anorectal medicine of our hospital from January 2020 to June 2022.Mayo total score and Truelove-Witts score were used to evaluate clinical activity.Patients with Mayo score>2 was defined as clinically active UC,and patients with Mayo score≤2 was defined as clinically remission.The histological activity was evaluated by Riley score.Evaluation of endoscopic activity of UC patients by Mayo endoscopic score.Results:Among the 158 patients included in the analysis,111 were in remission phase and the remaining 47 were in clinical active phase.Compared with the remission group,the levels of albumin,lymphocytes,and PNI in the clinically active group reduced significantly(P<0.05),while the levels of CRP,fecal calprotectin,neutrophils,white blood cells,NPR,and NLR increased significantly(P<0.05).Fecal calprotectin,CRP,NPR,NLR were significantly positively correlated with Mayo endoscopic score,Riley score,Truelove Witts score,and Mayo total score(P<0.05),while PNI was significantly negatively correlated with Mayo endoscopic score,Truelove Witts score,and Mayo total score(P<0.05).The ROC curve analysis results showed that fecal calprotectin and NPR had similar performance in predicting clinical activity in UC patients(AUC=0.868,0.850),followed by PNI(AUC=0.770)and NLR(AUC=0.756);Fecal calprotectin had the highest performance in predicting endoscopic activity in UC patients(AUC=0.840),followed by NPR(AUC=0.731),NLR(AUC=0.677),and PNI(AUC=0.671).Conclusions:NPR has demonstrated sufficient diagnostic utility in identifying UC patients with clinical and endoscopic activity,and is comparable in diagnostic performance to the fecal biomarker calprotectin.However,PNI has lower performance as a monitoring tool for UC disease activity.
作者
陶汉丽
王殊
刘康
邹琴
龚维
李凤
TAO Han-li;WANG Shu;LIU Kang;ZOU Qin;GONG Wei;LI Feng(Department of Anorectal Medicine,The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan,China)
出处
《肠外与肠内营养》
北大核心
2025年第4期223-228,共6页
Parenteral & Enteral Nutrition
基金
湖南省卫生健康委科研计划项目(D202203201596)。
