2026 年第 4 期 第 21 卷

C反应蛋白-白蛋白-淋巴细胞指数与大动脉炎患者疾病活动度的关系

Relationship between C-reactive protein-albumin-lymphocyte index and disease activity in patients with Takayasu arteritis

作者：张立秋潘丽丽杜娟慈维苹廖华李涛涛刘雪艳李芊谦张美佳

英文作者：Zhang Liqiu Pan Lili Du Juan Ci Weiping Liao Hua Li Taotao Liu Xueyan Li Qianqian Zhang Meijia

单位：首都医科大学附属北京安贞医院风湿免疫科，北京100029

英文单位：Department of Rheumatology and Immunology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：大动脉炎；C反应蛋白-白蛋白-淋巴细胞指数；疾病活动度；营养炎症指标

英文关键词：Takayasuarteritis;C-reactiveprotein-albumin-lymphocyteindex;Diseaseactivity;Nutritionalinflammatoryindex

• 摘要：

• 目的 探讨C反应蛋白-白蛋白-淋巴细胞 (CALLY）指数与大动脉炎患者疾病活动度的关系，并评估其对疾病活动度的预测价值。方法 收集首都医科大学附属北京安贞医院风湿免疫科2016年1月至2024年4月收治的92例大动脉炎住院患者的病历资料进行回顾性分析。根据2010年印度大动脉炎评估标准将患者分为非活动期组（41例）和活动期组（51例）。采用Logistic回归模型分析CALLY指数与疾病活动度的关系，进行亚组分析评估不同人群中的关联性，并通过限制性立方样条（RCS）和受试者工作特征（ROC）曲线分析评估CALLY指数的预测能力。结果 活动期组CALLY指数显著低于非活动期组［0.6（0.4,1.2)比2.2（0.8,5.3），P＜0.001］。多元Logistic回归分析表明，调整吸烟、饮酒及红细胞沉降率等混杂因素后CALLY指数与疾病活动风险呈负相关（比值比=0.67，95%置信区间：0.50～0.90，P=0.008）。按CALLY三分位数分组分析显示，与Q1组（最低三分位数左侧区间）相比，Q2组和Q3组均显示显著保护效应，趋势性检验P＜0.001。RCS分析显示，CALLY指数与疾病活动度之间呈线性负相关关系（P整体=0.013，P非线性=0.579）。ROC曲线分析显示，CALLY指数的曲线下面积（AUC）为0.737（95%置信区间：0.629~0.828），优于控制营养状态评分（AUC=0.631）和预后营养指数（AUC=0.651）。亚组分析显示，在女性、非高血压病、非糖尿病、非冠心病、非脑卒中、非饮酒、非吸烟、体重指数＜25 kg/m2的患者中CALLY指数与疾病活动度的负相关更显著。在不同高血压、糖尿病、脑卒中状态、饮酒习惯、年龄（以45岁为界）及体重指数（以25 kg/m2为界）分层中，CALLY指数与疾病活动度的关联在各亚组间保持相对一致，未观察到显著的交互效应（交互P值均＞0.05）。结论 CALLY指数与大动脉炎疾病活动度存在独立的负相关关系，具有良好的预测价值，可作为临床评估大动脉炎疾病活动度的有效且简便的工具。

• Objective To investigate the relationship between C-reactive protein-albumin-lymphocyte (CALLY) index and disease activity in patients with Takayasu arteritis, and to evaluate its predictive value for disease activity. Methods Medical records of 92 hospitalized patients with Takayasu arteritis admitted to the Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University from January 2016 to April 2024 were collected and retrospectively analyzed. Patients were divided into inactive group (41 cases) and active group (51 cases) according to the Indian Takayasu Arteritis Score 2010. Logistic regression model was used to analyze the relationship between CALLY index and disease activity, subgroup analysis was performed to assess the correlation in different populations, and the predictive ability of CALLY index was evaluated by restricted cubic spline (RCS) and receiver operating characteristic (ROC) curve analysis. Results The CALLY index in the active group was significantly lower than that in the inactive group ［0.6（0.4,1.2) vs 2.2（0.8,5.3）, P＜0.001］. Multivariate Logistic regression analysis showed that after adjusting for confounding factors such as smoking, drinking and erythrocyte sedimentation rate, the CALLY index was negatively correlated with disease activity risk (odds ratio=0.67, 95% confidence interval: 0.50-0.90, P=0.008). Analysis by CALLY tertile grouping showed that compared with Q1 group (left interval of the lowest tertile), both Q2 and Q3 groups showed significant protective effects, with a trend test P<0.001. RCS curve analysis showed a linear negative correlation between CALLY index and disease activity (P overall=0.013, P nonlinear=0.579). ROC curve analysis showed that the area under the curve (AUC) of CALLY index was 0.737 (95% confidence interval: 0.629-0.828), which was better than the controlling nutritional status score (AUC=0.631) and prognostic nutritional index (AUC=0.651). Subgroup analysis showed that the negative correlation between CALLY index and disease activity was more significant in female, non-hypertensive, non-diabetic, non-coronary heart disease, non-stroke, non-drinking, non-smoking patients, and those with body mass index <25 kg/m2. In stratifications by different hypertension, diabetes, stroke states, drinking habit, age (cut-off at 45 years) and body mass index (cut-off at 25 kg/m2), the association between CALLY index and disease activity remained relatively consistent across subgroups, and no significant interaction effect was observed (all P for interaction >0.05). Conclusion There is an independent negative correlation between CALLY index and disease activity in Takayasu arteritis, with good predictive value. It can be used as an effective and simple tool for clinical evaluation of disease activity in Takayasu arteritis.