血清铜/锌、血乳酸/白蛋白比值联合粪便钙卫蛋白评估溃疡性结肠炎病情及治疗结局的研究

doi:10.11958/20252176

天津医药 ›› 2026, Vol. 54 ›› Issue (1): 78-83.doi: 10.11958/20252176

血清铜/锌、血乳酸/白蛋白比值联合粪便钙卫蛋白评估溃疡性结肠炎病情及治疗结局的研究

林鑫星¹(), 蒋艳红², 胡顺明³, 王加亮¹, 刘晨路¹, 徐速⁴^,^△()

1 盐城市大丰人民医院胃肠外科（邮编224100）
2 盐城市大丰人民医院中医肿瘤科（邮编224100）
3 盐城市大丰人民医院消化内科（邮编224100）
4 南京中医药大学附属盐城中医院肛肠科

收稿日期:2025-05-29 修回日期:2025-10-17 出版日期:2026-01-15 发布日期:2026-01-19
通讯作者: ^△ E-mail：xstcm81@yeah.net
作者简介:林鑫星（1983），男，副主任医师，主要从事胃肠道肿瘤及炎症性肠病规范化诊疗方面研究。E-mail：623986524@qq.com
基金资助:
江苏省中医药管理局项目(MS2021071)

Study of serum copper/zinc ratio and lactate/albumin ratio combined with fecal calprotectin in evaluating the condition and treatment outcome of ulcerative colitis

LIN Xinxing¹(), JIANG Yanhong², HU Shunming³, WANG Jialiang¹, LIU Chenlu¹, XU Su⁴^,^△()

1 Department of Gastrointestinal Surgery, Dafeng People's Hospital, Yancheng 224100 China
2 Department of Carcinoma Traditional Chinese Medicine, Dafeng People's Hospital, Yancheng 224100 China
3 Department of Gastroenterology, Dafeng People's Hospital, Yancheng 224100 China
4 Department of Anorectal Surgery, Yancheng TCM Hospital Affiliated to Nanjing University of Chinese Medicine

Received:2025-05-29 Revised:2025-10-17 Published:2026-01-15 Online:2026-01-19
Contact: ^△ E-mail：xstcm81@yeah.net

林鑫星, 蒋艳红, 胡顺明, 王加亮, 刘晨路, 徐速. 血清铜/锌、血乳酸/白蛋白比值联合粪便钙卫蛋白评估溃疡性结肠炎病情及治疗结局的研究[J]. 天津医药, 2026, 54(1): 78-83.

LIN Xinxing, JIANG Yanhong, HU Shunming, WANG Jialiang, LIU Chenlu, XU Su. Study of serum copper/zinc ratio and lactate/albumin ratio combined with fecal calprotectin in evaluating the condition and treatment outcome of ulcerative colitis[J]. Tianjin Medical Journal, 2026, 54(1): 78-83.

摘要/Abstract

摘要：

目的探究血清铜/锌、血乳酸（LA）/白蛋白（ALB）比值（LAR）联合粪便钙卫蛋白（FC）对溃疡性结肠炎（UC）病情及治疗结局的评估价值。方法选取154例活动期UC患者并依据病情分为轻度活动组45例、中度活动组61例与重度活动组48例；另根据治疗结局分为好转组106例与未好转组48例。比较不同组血清铜/锌比值、LAR、FC等实验室指标水平，分析指标与UC患者病情及治疗结局的关系。结果轻度活动组、中度活动组、重度活动组的血清铜/锌比值、LAR、FC水平依次升高（P<0.05）；与轻度活动组比较，重度活动组血清前白蛋白（PAB）水平低（P<0.05）；与好转组比较，未好转组血清铜/锌比值、LAR、FC水平高（P<0.05）；Spearman相关性分析显示，UC患者血清铜/锌比值、LAR、FC水平与UC内镜下严重程度指数（UCEIS）评分呈正相关（P<0.05）；多因素Logistic回归分析显示，血清铜/锌比值、LAR、FC水平升高为UC病情加重及治疗结局未好转的危险因素（P<0.05）；受试者工作特征（ROC）曲线分析显示，血清铜/锌比值、LAR、FC联合评估UC病情加重及治疗结局未好转的曲线下面积（AUC）分别为0.949（95%CI：0.902~0.978）、0.936（95%CI：0.885~0.969）。结论血清铜/锌比值、LAR、FC可作为预测病情及治疗结局的可靠生物标志物，且指标联合预测效能更佳。

关键词: 结肠炎, 溃疡性, 铜, 锌, 白细胞L1抗原复合物, 乳酸, 血清白蛋白, 粪便钙卫蛋白

Abstract:

Objective To explore the value of serum copper/zinc ratio and lactate (LA)/albumin (ALB) ratio (LAR) combined with fecal calprotectin (FC) in evaluating the condition and treatment outcome of ulcerative colitis (UC). Methods A total of 154 patients with active UC were selected and divided into the mild activity group (45 cases), the moderate activity group (61 cases) and the severe activity group (48 cases) according to their disease condition. Based on the treatment outcome, patients were divided into the improved group (106 cases) and the unimproved group (48 cases). Laboratory indices such as serum copper/zinc ratio, LAR and FC were compared between groups. The relationship between these indices and the condition and treatment outcome of patients with UC was analyzed. Results Serum copper/zinc ratio, LAR and FC levels increased in sequence in the mild activity group, the moderate activity group and the severe activity group (P<0.05). Compared with the mild activity group, serum prealbumin level was lower in the severe activity group (P<0.05). Compared with the improved group, the unimproved group demonstrated higher serum copper/zinc ratio, LAR and FC levels (P<0.05). Spearman correlation analysis showed that serum copper/zinc ratio, LAR and FC levels were positively correlated with UCEIS score in patients with UC (P<0.05). Multivariate Logistic regression analysis showed that increased serum copper/zinc ratio, LAR and FC levels were risk factors for aggravation and unimproved treatment outcomes of UC (P<0.05). The receiver operating characteristic (ROC) curve analysis showed that the areas under the curve (AUCs) of combination of serum copper/zinc ratio, LAR and FC in predicting aggravation and no improvement of UC were 0.949 (95%CI: 0.902-0.978) and 0.936 (95%CI: 0.885-0.969), respectively. Conclusion Serum copper/zinc ratio, LAR and FC can serve as reliable biomarkers for predicting the condition and treatment outcome of UC. Combined use of these indices can achieve better predictive efficacy.

Key words: colitis, ulcerative, copper, zinc, leukocyte L1 antigen complex, lactic acid, serum albumin, fecal calprotectin

中图分类号:

R574.62

图/表 9

参考文献 25

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组别	n	性别（男/女）	年龄/ 岁	吸烟	病程/ 月	BMI/ （kg/m²）
轻度活动组	45	27/18	33.62±5.16	6（13.3）	24.60±6.09	22.64±2.53
中度活动组	61	40/21	34.11±4.84	11（18.0）	25.08±6.27	22.97±2.22
重度活动组	48	35/13	34.58±5.10	9（18.8）	25.71±7.05	23.12±2.09
χ²或F		1.752	0.426	0.581	0.344	0.541

组别	n	性别（男/女）	年龄/ 岁	吸烟	病程/ 月	BMI/ （kg/m²）
轻度活动组	45	27/18	33.62±5.16	6（13.3）	24.60±6.09	22.64±2.53
中度活动组	61	40/21	34.11±4.84	11（18.0）	25.08±6.27	22.97±2.22
重度活动组	48	35/13	34.58±5.10	9（18.8）	25.71±7.05	23.12±2.09
χ²或F		1.752	0.426	0.581	0.344	0.541

组别		n	PAB/（mg/L）		SUA/（μmol/L）		CysC/（mg/L）
轻度活动组		45	210.40±45.04		193.89±42.76		0.82±0.24
中度活动组		61	200.68±37.25		198.01±48.76		0.85±0.20
重度活动组		48	183.62±35.49^a		198.99±51.24		0.86±0.19
F或χ²			5.630^＊＊		0.150		0.573
组别	血清铜/锌比值			LAR		FC/（μg/g）
轻度活动组	1.47（1.11，1.91）			0.05（0.04，0.06）		156.60±43.08
中度活动组	2.26（1.77，3.07）^a			0.08（0.06，0.10）^a		236.48±69.29^a
重度活动组	3.33（2.29，4.58）^ab			0.12（0.08，0.15）^ab		318.63±94.78^ab
F或χ²	56.627^＊＊			84.480^＊＊		58.191^＊＊

组别		n	PAB/（mg/L）		SUA/（μmol/L）		CysC/（mg/L）
轻度活动组		45	210.40±45.04		193.89±42.76		0.82±0.24
中度活动组		61	200.68±37.25		198.01±48.76		0.85±0.20
重度活动组		48	183.62±35.49^a		198.99±51.24		0.86±0.19
F或χ²			5.630^＊＊		0.150		0.573
组别	血清铜/锌比值			LAR		FC/（μg/g）
轻度活动组	1.47（1.11，1.91）			0.05（0.04，0.06）		156.60±43.08
中度活动组	2.26（1.77，3.07）^a			0.08（0.06，0.10）^a		236.48±69.29^a
重度活动组	3.33（2.29，4.58）^ab			0.12（0.08，0.15）^ab		318.63±94.78^ab
F或χ²	56.627^＊＊			84.480^＊＊		58.191^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
PAB	-0.007	0.008	0.734	0.392	0.993	0.977~1.009
血清铜/ 锌比值	0.781	0.249	9.821	0.002	2.183	1.340~3.557
LAR	0.388	0.099	15.454	<0.001	1.473	1.214~1.787
FC	0.020	0.005	20.086	<0.001	1.020	1.011~1.029
常数项	-10.622	2.722	15.222	<0.001	0.000	-

血清铜/锌、血乳酸/白蛋白比值联合粪便钙卫蛋白评估溃疡性结肠炎病情及治疗结局的研究

Study of serum copper/zinc ratio and lactate/albumin ratio combined with fecal calprotectin in evaluating the condition and treatment outcome of ulcerative colitis

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指标	AUC	95% CI	截断值	敏感度/ %	特异度/ %	约登指数
血清铜/ 锌比值	0.803	0.731~0.863	2.64	72.92	77.36	0.503
LAR	0.842	0.774~0.895	0.10	66.67	88.68	0.554
FC	0.833	0.764~0.888	270.53 μg/g	64.58	84.91	0.495
指标联合	0.949	0.902~0.978	-	83.33	89.62	0.730

组别	n	血清铜/锌比值	LAR	FC/（μg/g）
A组	106	1.90（1.34，2.53）	0.06（0.05，0.09）	202.08（148.36，261.78）
B组	48	3.46（2.69，4.93）	0.12（0.07，0.16）	332.78（211.42，380.89）
Z		6.608^＊＊	6.058^＊＊	5.141^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
血清铜/ 锌比值	1.125	0.256	19.295	<0.001	3.081	1.865~5.090
LAR	0.302	0.080	14.108	<0.001	1.352	1.155~1.583
FC	0.012	0.003	13.030	<0.001	1.012	1.005~1.019
常数项	-9.843	1.638	36.125	<0.001	0.000	-

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