Abstract:

Objective

To analyze the guiding value of submucosal index combined with C-reactive protein/albumin ratio (CRP/ALB), procalcitonin (PCT), interleukin (IL)-6 and IL-8 in the treatment of patients with moderate to severe ulcerative colitis (UC).

Methods

A total of 174 patients with moderate to severe UC in Qionglai Medical Center Hospital from January 2022 to January 2024 were selected, all of them were treated with standardized treatment, and colonoscopy was performed after 2 months of treatment to evaluate the therapeutic effect, and they were divided into remission group and non-remission group according to the curative effect of patients. The differences of submucosal index,CRP/ALB, PCT, IL-6 and IL-8 between the two groups were compared before treatment and 2 months after treatment, and the baseline data of the two groups were compared. Logistic multivariate regression analysis was used to summarize the related factors affecting the treatment effect of patients, and receiver operating characteristic curve (ROC) was used to calculate the efficacy and area under the curve (AUC) of each factor to predict the treatment effect of patients individually and jointly.

Results

After 2 months of treatment, 121 patients reached the effective standard of treatment, and the effective rate was 69.54%.Compared with before treatment, the submucosal index, CRP/ALB, PCT, IL-6 and IL-8 in remission group and non-remission group decreased after 2 months of treatment. Compared with the non-remission group,the submucosal index, CRP/ALB, PCT, IL-6 and IL-8 in the remission group were lower before and after treatment for 2 months (all P＜0.05). Logistic multivariate regression analysis showed that severe UC,submucosal index≥50%, CRP/ALB≥0.55, PCT≥1.44 ng/mL, IL-6≥52.17 ng/L and IL-8≥48.15 ng/L were all independent risk factors affecting the therapeutic effect of patients with moderate to severe UC (all P＜0.05). ROC curve showed that the AUC of UC severity combined with submucosal index, CRP/ALB,PCT, IL-6 and IL-8 was 0.931, and the sensitivity and specificity were 96.69% and 84.91% respectively.

Conclusion

The overall effective rate of moderate to severe UC patients is low, which is related to the patient's condition, submucosal index, laboratory indicators and other factors. Combining the above factors can provide reliable reference for predicting the therapeutic effect of patients.

Key words: Ulcerative colitis, Transabdominal ultrasound, Submucosal index, Treatment effect