成人过敏性紫癜胃肠道出血与中性粒细胞／淋巴细胞比值及血小板／淋巴细胞比值的关系

Relationship of gastrointestinal bleeding with neutrophil-to.lymphocyte ratio and platelet-to-lymphocyte ratio in adult patients with Henoch-Schonlein purpura

目的 探讨中性粒细胞/淋巴细胞比值（NLR）及血小板/淋巴细胞比值（PLR）与成人过敏性紫癜胃肠道出血的关系。方法 对115例成人过敏性紫癜的血常规指标、C反应蛋白、血细胞沉降率进行回顾性分析，计算NLR及PLR，并与100例健康人的指标比较。用logistic回归分析确定与成人过敏性紫癜胃肠道出血相关的变量，用受试者工作特征曲线确定变量的预测效能。结果 成人过敏性紫癜患者的NLR、PLR较健康对照组升高（均P 〈 0.05），有胃肠道出血的过敏性紫癜患者NLR、PLR、CRP水平明显高于无出血的患者（均P 〈 0.05）。logistic回归分析显示，NLR是成人过敏性紫癜胃肠道出血的独立危险因素（P 〈 0.05）。ROC曲线显示，NLR截点值为3.24时，预测过敏性紫癜胃肠道出血的效能最高，其敏感度为85.1%，特异性为71.3%。结论 成人过敏性紫癜患者的NLR、PLR明显升高，尤其是伴有胃肠道出血时。NLR是成人过敏性紫癜胃肠道出血的潜在预测因子。

Objective To explore the relationship of neutrophil-to-lymphocyte ratio （NLR） and platelet-to-lymphocyte ratio （PLR） with gastrointestinal bleeding in adult patients with Henoch-Sch？nlein purpura （HSP）. Methods Laboratory data including routine blood test results, C-reactive protein （CRP） levels and erythrocyte sedimentation rate （ESR） were collected from 115 adult patients with HSP and 100 healthy controls, and retrospectively analyzed. NLR and PLR were calculated and compared. Logistic regression analysis was used to determine variables associated with gastrointestinal bleeding in adult patients with HSP, and the receiver operating characteristic （ROC） curve was drawn to estimate the predictive efficacy of these variables. Results NLR and PLR were both significantly higher in adult patients with HSP than in healthy controls （both P 〈 0.05）, and NLR, PLR and CRP levels were all significantly higher in adult HSP patients with gastrointestinal bleeding than in those without （all P 〈 0.05）. Logistic regression analysis showed that NLR was an independent risk factor for gastrointestinal bleeding in adult HSP patients （P 〈 0.05）. The ROC curve revealed that the optimal cut-off point of NLR for predicting gastrointestinal bleeding was 3.24 in adult patients with HSP, with the sensitivity and specificity being 85.1% and 71.3% respectively. Conclusions Both NLR and PLR evidently increase in adult patients with HSP, especially in those with gastrointestinal bleeding. NLR is a potential predictor for gastrointestinal bleeding in adult patients with HSP.