首页|C反应蛋白与白蛋白比值与重症COVID-19患者中医卫气营血证型的相关性

C反应蛋白与白蛋白比值与重症COVID-19患者中医卫气营血证型的相关性

The correlation between the ratio of C-reactive protein to albumin and Wei-Qi-Ying-Xue syndrome in patients with severe COVID-19

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目的 探讨C反应蛋白与白蛋白比值(CAR)与重症新型冠状病毒感染(COVID-19)患者的中医卫气营血证型的相关性.方法 采用病例对照研究,选取2022年12月至2023年12月北京中医药大学东直门医院收治的63例重症COVID-19患者,包括重型50例,危重型13例,收集患者临床资料,根据卫气营血辨证纳入气分证21例、营分证20例、血分证22例,比较不同卫气营血证型患者CRP、ALB水平及CAR的差异,Spearman检验CRP、ALB、CAR与中医卫气营血证型的相关性,并采用受试者工作特征(ROC)曲线检测CRP、ALB、CAR对中医卫气营血证型的诊断效能.结果 不同卫气营血证型的三组患者在西医临床分型方面差异有统计学意义(P<0.05),而在年龄、合并症方面差异无统计学意义(均P>0.05).营分组、血分组CAR均高于气分组(均P<0.05),血分组CRP高于气分组(P<0.05),营分组、血分组ALB低于气分组(均P<0.05).ROC曲线分析显示,CRP、ALB、CAR对气分证、血分证有良好诊断价值(P<0.05),诊断气分证的临界值分别为48.57 mg/L、34.20 g/L、2.97,诊断血分证的临界值分别为28.30 mg/L、26.60 g/L、5.96.结论 CAR与重症COVID-19患者卫气营血证型存在相关性,其水平变化符合卫气营血演变规律,CAR≤2.97有助于诊断气分证,CAR>5.96有助于诊断血分证,CAR或可成为重症COVID-19患者与中医卫气营血证型相关的一项客观指标.
Objective To explore the correlation between the ratio of C-reactive protein(CRP)to albumin(CAR)and the syndrome type of Wei-Qi-Ying-Xue in patients with severe coronavirus disease 2019(COVID-19).Methods A case-control study was conducted to select 63 severe patients with COVID-19 admitted to the Dongzhimen Hospital of Beijing University of Chinese Medicine from December 2022 to December 2023,including 50 severe cases and 13 critical cases.The clinical data of the patients were collected.According to the syndrome differentiation of Wei-Qi-Ying-Xue,there were 21 cases of Qi syndrome,20 cases of Ying syndrome and 22 cases of Xue syndrome.The differences of CRP,ALB and CAR levels in patients with different Wei-Qi-Ying-Xue syndromes were compared.Spearman correlation test was used to test the correlation between CRP,ALB,CAR and the Wei-Qi-Ying-Xue syndrome type,and the receiver operating characteristic(ROC)curve was used to detect the diagnostic efficacy of CRP,ALB and CAR on the Wei-Qi-Ying-Xue syndrome type.Results There was a statistically significant difference in the clinical classification of Western medicine among the three groups(P<0.05).The CAR of the Ying group and the Xue group was higher than that of the Qi group(P<0.05),while there was no statistically significant difference in age and comorbidities(all P>0.05).The CRP of the Xue group was higher than that of the Qi group(P<0.05),and the ALB of the Ying group and the Xue group was lower than that of the Qi group(all P<0.05).Correlation analysis showed that there was a correlation between the Wei-Qi-Ying-Xue syndrome type and CRP,ALB and CAR(P<0.05),among which CAR changed most significantly with the change of Wei-Qi-Ying-Xue syndrome type.ROC curve analysis showed that CRP,ALB and CAR had good diagnostic value for Qi syndrome and Xue syndrome(P<0.05).The critical values of the diagnosis of Qi syndrome were 48.57 mg/L,34.20 g/L and 2.97.The critical values of the diagnosis of Xue syndrome were 28.30 mg/L,26.6 g/L and 5.96.Conclusions CAR ratio is correlated with the Wei-Qi-Ying-Xue syndrome type of severe COVID-19 patients,and its level changes are in line with the evolution law of Wei-Qi-Ying-Xue syndrome.CAR≤2.97 is contributed to the diagnosis of Qi syndrome,and CAR>5.96 is contributed to the diagnosis of Xue syndrome.CAR may be an objective index related to the Wei-Qi-Ying-Xue syndrome type of severe COVID-19 patients.

COVID-19C-reactive proteinSerum albuminSyndrome differentiation of Defense Qi,Nutrient and Blood

李兰、吴彩军、马林沁、菅原蓁、苏家卉、刘峻溪、赵艺源子

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北京中医药大学东直门医院急诊科,北京 100700

北京中医药大学脓毒症研究所,北京 100700

新型冠状病毒感染 C反应蛋白质 血清白蛋白 卫气营血辨证

国家中医药管理局新型冠状病毒感染中医药应急专项

2023ZYLCYJ02-1

2024

中国医师杂志
中华医学会 湖南省医学会

中国医师杂志

CSTPCD
影响因子:0.876
ISSN:1008-1372
年,卷(期):2024.26(2)
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