术后C反应蛋白与白蛋白比值与结直肠癌术后并发症的相关性研究

目的探讨术后C反应蛋白和白蛋白比值(CAR)与结直肠癌患者术后并发症的相关性。方法收集于解放军总医院海南医院普通外科2013年1月至2018年7月行择期手术治疗的312例结直肠癌患者的临床资料。男性188例,女性124例,年龄(61.0±12.9)岁(范围:21~86岁)。采用Logistic回归分析术后并发症发生的相关因素,采用受试者工作特征曲线确定CAR的最佳截点值,并计算曲线下面积,比较CAR与C反应蛋白对术后并发症的预测效能。结果 28.5%(89/312)的患者发生术后并发症。术后第3天血红蛋白(OR=0.977,95%CI:0.957~0.998,P=0.034)、术前C反应蛋白(OR=1.209,95%CI:1.055~1.386,P=0.006)、术后第3天CAR≥0.325(OR=0.033,95%CI:0.016~0.067,P<0.01)是结直肠癌术后并发症发生的独立相关因素。术后第3天CAR的最佳截点值为0.325,曲线下面积为0.872;术前C反应蛋白的最佳截点值为1.735 g/L,曲线下面积为0.626;术后第3天CAR较术前C反应蛋白具有更高的阳性预测值(79.9%比55.1%)。结论术后CAR与结直肠癌患者术后并发症发生密切相关,术后第3天CAR≥0.325的结直肠癌患者术后并发症发生率升高。

The correlations between C-reactive protein to albumin ratio and postoperative complications in patients with colorectal surgery

Objective To examine the correlations of C-reactive protein(CRP)/albumin ratio(CAR)with the postoperative complications of patients with colorectal cancer.Methods The clinic data of 312 patients undergoing elective surgery for colorectal cancer in Hainan Hospital of People′s Liberation Army General Hospital between January 2013 and July 2018 was analyzed retrospectively.There were 188 males and 124 females,aged(61.0±12.9)years(range:21 to 86 years).Logistic analysis was used to identify relative factors for postoperative complications.Receiver operating characteristic curves were developed to examine the cutoff values and compare diagnostic accuracy of the CAR and CRP levels.Results Postoperative complications occured in 28.5%(89/312)cases.Hemoglobin on postoperative day(POD)3(OR=0.977,95%CI:0.957 to 0.998,P=0.034),preoperative CRP(OR=1.209,95%CI:1.055 to 1.386,P=0.006)and CAR on POD 3(OR=0.033,95%CI:0.016 to 0.067,P<0.01)were found to be significant independent relative factors for postoperative complications.The cutoff point of CAR on POD 3 was 0.325,patients with CAR≥0.325 were found to have more postoperative complications than those with CAR<0.325.The area under the curve of CAR on POD 3 and preoperative CRP were 0.872,0.626,respectively.The positive predictive value of CAR on POD 3 was higher than that of preoperative CRP(79.9%vs.55.1%).Conclusions CAR is closely related to the occurrence of postoperative complications in colorectal surgery.Patients with CAR≥0.325 on POD 3 has higher incidence of postoperative complications.