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原发性膝骨关节炎患者CRP/PAB比值与病情严重性、发病的关系

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目的 探讨原发性膝骨关节炎(KOA)患者C反应蛋白/前清蛋白(CRP/PAB)比值与病情严重性、发病的关系.方法 选取2021年2月至2023年1月海南西部中心医院收治的93例原发性KOA患者作为本次研究对象(KOA组),根据Kellgren-Lawrence(KL)分级将患者分为轻中度组66例(KL分级1~3级)、重度组27例(KL分级4级).另外选取同时期来本院进行体检的130名健康人作为对照组.比较KOA组与对照组、KOA患者轻中度组与重度组血清CRP、PAB水平及CRP/PAB比值情况;采用受试者工作特性(ROC)曲线评估CRP、PAB、CRP/PAB比值对原发性KOA患者病情的预测价值;采用二分类Logistic逐步回归分析探讨原发性KOA患者发病的影响因素.结果 KOA组血清CRP水平和CRP/PAB比值高于对照组,PAB水平低于对照组,差异有统计学意义(P<0.05).重度组血清CRP水平和CRP/PAB比值高于轻中度组,PAB水平低于轻中度组,差异有统计学意义(P<0.05).CRP、PAB、CRP/PAB比值预测原发性KOA患者病情的曲线下面积(AUC)分别为0.849(0.797~0.901)、0.751(0.699~0.803)、0.903(0.851~0.955),截点值分别为52.55 mg/L、172.77 mg/L、0.37,特异度分别为0.680、0.571、0.870,灵敏度分别为0.913、0.913、0.845.二分类Logistic逐步回归分析显示,高龄(OR=2.368,95%CI:1.584~3.539)、有KOA家族史(OR=2.158,95%CI:1.475~3.156)、CRP/PAB比值≥0.37(OR=2.782,95%CI:1.797~4.306)是原发性KOA患者发病的独立危险因素(P<0.05).结论 血清CRP/PAB比值升高与原发性KOA的发病和病情严重程度密切相关,可作为预测原发性KOA患者病情的潜在生物标记物,有一定的临床应用价值.
Relationship between CRP/PAB ratio and severity or onset in patients with primary knee osteoarthritis
Objective To explore the relationship between the C-reactive protein/prealbumin (CRP/PAB) ratio and the severity and onset of the disease in patients with primary knee osteoarthritis (KOA).Methods 93 patients with primary KOA admitted to Hainan Western Central Hospital from February 2021 to January 2023 were selected as the subjects of this study (KOA group).According to the Kellgren Lawrence (KL) classification,the patients were divided into a mild to moderate group of 66 cases (KL grading 1-3) and a severe group of 27 cases (KL grading 4).In addition,130 healthy individuals who came to our hospital for physical examinations during the same period were selected as the control group.The study aimed to compare the serum CRP,PAB levels,and CRP/PAB ratio between the KOA group and the control group,as well as between the mild to moderate group and the severe group.The predictive value of CRP,PAB,and the CRP/PAB ratio on the condition of primary KOA patients was evaluated using receiver operating characteristic (ROC) curves.The influencing factors of primary KOA patients were identified using binary logistic stepwise regression analysis.Results The serum CRP level and the CRP/PAB ratio in the KOA group were higher than those in the control group,while the PAB level was lower than that in the control group,with statistical sig-nificance (P<0.05).The serum CRP level and the CRP/PAB ratio in the severe group were higher than those in the mild to moderate group,and the PAB level was lower than that in the mild to moderate group,with statisti-cal significance (P<0.05).The area under the curve (AUC) of CRP,PAB and CRP/PAB ratio in predicting the disease condition of patients with primary KOA were 0.849 (0.797~0.901),0.751 (0.699~0.803) and 0.903 (0.851~0.955),respectively.Cut-off values were 52.55 mg/L,172.77 mg/L and 0.37,the specificity was 0.680,0.571 and 0.870,and the sensitivity was 0.913,0.913 and 0.845,respectively.Old age (OR=2.368,95%CI:1.584~3.539),family history of KOA (OR=2.158,95%CI:1.475~3.156),CRP/PAB ratio was ≥0.37(OR=2.782,95%CI:1.797~4.306) were independent risk factors for primary KOA patients (P<0.05).Conclusion The increase in the CRP/PAB ratio in serum is closely related to the onset and severity of primary KOA.This ratio can be used as a potential biomarker to predict the disease in primary KOA patients and has certain clinical application value.

Primary knee osteoarthritisC-reactive protein/prealbumin ratioDisease conditioninfluence factor

张恒林、钟开义、李梅桂、符妹垂

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海南西部中心医院骨科,海南,儋州 571700

海南西部中心医院肾内科,海南,儋州 571700

海南西部中心医院肿瘤内科,海南,儋州 571700

海南西部中心医院超声科,海南,儋州 571700

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原发性膝骨关节炎 C反应蛋白/前清蛋白比值 病情 影响因素

海南省卫生健康行业科研项目

20A200008

2024

分子诊断与治疗杂志
中山大学

分子诊断与治疗杂志

CSTPCD
影响因子:0.65
ISSN:1674-6929
年,卷(期):2024.16(7)