Relationship Between C-reactive Protein/Albumin Ratio and Disease Condition,Disease Outcome in Patients with Active Pul-monary Tuberculosis
Objective To explore the relationship between C-reactive protein/albumin ratio(CAR)and the disease condition,disease outcome in patients with active pulmonary tuberculosis.Methods The clinical data of 143 patients with active pulmonary tuberculosis admitted to author's hospital from January to June 2023 were retrospectively analyzed.According to the disease condition,the patients were divided into mild group(n=51),moderate group(n=65)and se-vere group(n=27).Before treatment,the levels of C-reactive protein and albumin in peripheral blood were detected by automatic blood cell analyzer and automatic biochemical analyzer,and the CAR of the two was calculated.According to the outcome of 6 months of standard treatment,the patients were divided into good prognosis group(n=104)and poor prognosis group(n=39).The predictive value of C-reactive protein,albumin and CAR for the outcome of active pulmonary tuberculosis was evaluated by receiver operating characteristic(ROC),and the related factors for the outcome of active pulmonary tuberculosis were ex-plored by multivariate Logistic regression.Results The peripheral blood C-reactive protein level and CAR of patient with active pulmonary tuberculosis gradually increased in the mild,moderate and severe groups,while the level of albumin gradually decreased,and the difference was statistically significant(all P＜0.05).The peripheral blood C-reactive protein level and CAR of patient with active pulmonary tuberculosis in poor prognosis group were higher than those in good prog-nosis group,while the albumin level was lower than that in good prognosis group,and the difference was statistically sig-nificant(all P＜0.05).The area under the curve(AUC)of ROC and 95％confidence interval(CI)of C-reactive protein,albumin and CAR in predicting the prognosis of patients with active pulmonary tuberculosis were 0.858(95％CI:0.807-0.909),0.761(95％CI:0.750-0.812)and 0.903(95％CI:0.852-0.954),and the CAR had the highest predictive power.Univariate analysis showed that the proportion of aged 60 years,proportion of history of diabetes mellitus,proportion of concurrent pulmonary infection and white blood cell count(WBC),platelet count(PLT),erythrocyte sedi-mentation rate(ESR)and procalcitonin(PCT)active pulmonary tuberculosis in poor prognosis group were higher than those in good prognosis group,and the difference was statistically significant(all P＜0.05).Multivariate Logistic regres-sion analysis showed that concurrent pulmonary infection(OR=2.052,95％CI:1.425-2.955),high ESR level(OR=2.344,95％CI:1.581-3.476)and CAR≥2.47(OR=2.782,95％CI:1.790-4.323)were independent risk factors for poor prognosis in patients with active pulmonary tuberculosis.Conclusion The increase of CAR is associated with the ag-gravation of the disease and poor prognosis of patients with active pulmonary tuberculosis,which is expected to be used as a bio-marker for predicting the prognosis of patients with active pulmonary tuberculosis and with certain clinical application value.
Active pulmonary tuberculosisC-reactive protein/albumin ratioDisease severityDisease outcome
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