RPR与系统性红斑狼疮疾病活动度的关系研究

Study on the relationship between RPR and disease activity of systemic lupus erythematosus

目的探讨红细胞分布宽度-血小板计数比值(RPR)与系统性红斑狼疮(SLE)疾病活动度的关系。方法选取110例SLE患者作为研究组,根据SLE疾病活动度指数(SLEDAI)评分将研究组患者分为低疾病活动度组(58例)和高疾病活动度组(52例),另选取110例健康体检者作为对照组。比较研究组与对照组、低疾病活动度组与高疾病活动度组的一般资料与实验室指标;采用Spearman相关分析RPR、SLEDAI评分与SLE患者各实验室指标的相关性;采用受试者工作特征曲线(ROC曲线)评价RPR、血小板-淋巴细胞比值(PLR)、平均血小板体积(MPV)诊断SLE的效能,评价RPR预测SLE疾病活动度的效能。结果高疾病活动度组白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、中性粒细胞绝对值(NEUT)、淋巴细胞绝对值、补体C3、补体C4、清蛋白(ALB)水平均低于低疾病活动度组,MPV、RPR、红细胞沉降率(ESR)、免疫球蛋白G(IgG)、24 h尿蛋白定量、抗双链DNA(dsDNA)抗体水平均高于低疾病活动度组,差异均有统计学意义(P<0.05)。SLEDAI评分与红细胞分布宽度(RDW)、RPR、MPV、ESR、IgG、24 h尿蛋白定量和抗dsDNA抗体水平均呈正相关(P<0.05),与WBC、Hb、PLT、NEUT、PLR、补体C3、补体C4和ALB水平均呈负相关(P<0.05);RPR与RDW、MPV、ESR、抗dsDNA抗体、24 h尿蛋白定量水平均呈正相关(P<0.05),与Hb、PLT、NEUT、PLR、补体C3、补体C4和ALB水平均呈负相关(P<0.05)。ROC曲线分析结果显示,RPR诊断SLE的曲线下面积(AUC)为0.932,灵敏度为80.9%,特异度为89.1%,均高于PLR与MPV;RPR预测SLE疾病活动度的AUC为0.962。结论SLE患者存在RPR变化,且RPR在诊断SLE及预测SLE疾病活动度方面均具有较高的灵敏度与特异度。

Objective To explore the relationship between red blood cell distribution width platelet count ratio(RPR)and disease activity of systemic lupus erythematosus(SLE).Methods A total of 110 SLE patients were selected as the study group,according to the SLE disease activity index(SLEDAI)score,the patients in the study group were further divided into low disease activity group(58 cases)and high disease activity group(52 cases),another 110 healthy people were selected as control group.The general data and laboratory indexes of study group and control group,low disease activity group and high disease activity group were compared.Spearman correlation analysis was used to analyze the correlation between RPR,SLEDAI score and laboratory indexes of SLE patients.Receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic efficacy of RPR,platelet lymphocyte ratio(PLR)and mean platelet volume(MPV)in SLE,and the efficacy of RPR in predicting the disease activity of SLE.Results White blood cell count(WBC),hemoglobin(Hb),platelet count(PLT),neutrophil absolute value(NEUT),lymphocyte absolute value,complement C3,complement C4,albumin(ALB)levels in high disease activity group were lower than those in low disease activity group,MPV,RPR,erythrocyte sedimentation rate(ESR),immunoglobulin G(IgG),24 hour urine protein quantification and anti-double stranded DNA(dsDNA)antibody levels were higher than those in low disease activity group,the differences were statistically significant(P<0.05).SLEDAI score was positively correlated with red blood cell distribution width(RDW),RPR,MPV,ESR,IgG,24 hour urine protein quantification and anti-dsDNA antibody levels(P<0.05),and negatively correlated with WBC,Hb,PLT,NEUT,PLR,complement C3,complement C4 and ALB levels(P<0.05).RPR was positively correlated with RDW,MPV,ESR,anti-dsDNA antibody and 24 hour urine protein quantification levels(P<0.05),and negatively correlated with Hb,PLT,NEUT,PLR,complement C3,complement C4 and ALB level(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of RPR in the diagnosis of SLE was 0.932,the sensitivity was 80.9%,the specificity was 89.1%,which were higher than PLR and MPV.The AUC of RPR in predicting SLE disease activity was 0.962.Conclusion SLE patients have changes in RPR,and RPR has high sensitivity and specificity in diagnosing SLE and predicting SLE disease activity.