血小板/淋巴细胞比值和粒细胞/淋巴细胞比值与大动脉炎疾病活动性的关系

Association between platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio with disease activity in Takayasu arteritis patients

目的 探讨血小板/淋巴细胞比值（PLR）和中性粒细胞/淋巴细胞比值（NLR）与大动脉炎疾病活动性的关系.方法 采用回顾性研究方法,纳入2010年1月至2017年10月在西京医院临床免疫科住院的大动脉炎患者289例（大动脉炎组）,并从西京医院健康体检中心选取年龄和性别与大动脉炎组相匹配的健康者280例（对照组）.另外,根据Kerr评分将大动脉炎患者分为活动组（Kerr评分≥2分,180例）和非活动组（Kerr评分≤1分,109例）.对两组间的临床资料进行比较,采用Pearson相关分析评价PLR和NLR与Kerr评分、ESR和C反应蛋白（CRP）的关系,采用受试者工作特征（ROC）曲线确定判断大动脉炎疾病活动性的界值.结果 大动脉炎组的PLR和NLR均高于对照组[分别为137.33（97.38,193.37）比120.55（96.86,144.60）和2.38（1.76,3.57）比1.66（1.35,2.08）,P均〈0.001].活动组的PLR和NLR均高于非活动组[分别为163.43（123.64,224.15）比110.53（84.22,147.24）和2.59（1.96,3.94）比1.95（1.53,2.86）,P均〈0.001].活动组患者治疗6个月后的PLR和NLR均低于治疗前[分别为104.67（77.22,138.43）比164.05（123.29,226.29）和2.15（1.67,2.60）比2.58（1.96,3.91）,P均〈0.001].PLR与Kerr评分（r=0.439,P〈0.001）、CRP（r=0.328,P〈0.001）和ESR（r=0.410,P〈0.001）均呈正相关;NLR与Kerr评分（r=0.235,P〈0.001）、CRP（r=0.169,P=0.005）和ESR（r=0.123,P=0.037）也均呈正相关.PLR判断大动脉炎疾病活动性的最佳界值为176.709（敏感度为44.6％,特异度为93.0％,ROC曲线下面积为0.766）;NLR判断大动脉炎疾病活动性的最佳界值为2.128（敏感度为70.9％,特异度为47.7％,ROC曲线下面积为0.691）.结论 PLR和NLR可能有助于判断大动脉炎疾病活动性.

Objective To explore the relation between platelet-to-lymphocyte ratio （PLR） or neutrophil-to-lymphocyte ratio （NLR） with disease activity in Takayasu arteritis （TA） patients. Methods Present retrospective study involved 289 patients with TA, who were hospitalized in our department between January 2010 and October 2017, and 280 age and gender matched healthy controls, who underwent thealth examination in our health examination center during the same period （control group）. TA patients were further divided into active and inactive groups （180 and 109 cases respectively） according to Kerr scores. The clinical data were compared between groups. Pearson correlation analysis was used to evaluate the relationship between PLR or NLR and disease activity （Kerr score or C-reactive protein or erythrocyte sedimentation rate）. Receiver operating characteristic （ROC） curve was employed to judge the cut-off value of disease activity for TA patients. Results PLR and NLR were significantly higher in TA group than in control group（137.33（97.38, 193.37）vs. 120.55（96.86, 144.60）and 2.38（1.76, 3.57）vs. 1.66（1.35, 2.08）, respectively, all P〈0.001）. PLR and NLR were significantly higher in active TA group than in inactive TA group （163.43（123.64, 224.15）vs. 110.53（84.22, 147.24）and 2.59（1.96, 3.94）vs. 1.95（1.53, 2.86） respectively,all P〈0.001）. PLR and NLR of active group were significantly decreased after 6 months treatment （164.05 （123.29, 226.29）vs. 104.67 （77.22, 138.43）and 2.58 （1.96, 3.91）vs. 2.15 （1.67, 2.60） respectively, all P〈0.001）. PLR was positively correlated with Kerr score （r=0.439, P〈0.001）, C-reactive＆nbsp;protein （r=0.328, P〈0.001） and erythrocyte sedimentation rate （r=0.410, P〈0.001）. NLR also exhibited a positive relationship with Kerr score （r=0.235, P〈0.001）, C-reactive protein （r=0.169, P=0.005） and erythrocyte sedimentation rate （r=0.123, P=0.037）. A PLR level of 176.709 was shown to be the best predictive cut-off value for TA disease activity （sensitivity 44.6％, specificity 93.0％, and area under the curve=0.766）.A NLR level of 2.128 was shown to be the best predictive cut-off value for TA disease activity （sensitivity 70.9％, specificity 47.7％, and area under the curve=0.691）. Conclusion PLR and NLR are useful markers for predicting disease activity of TA patients.