痛风患者血液学参数与疾病活动性的关系

Correlation between hematological parameters and disease activity in patients with gout

目的分析平均血小板体积与血小板计数的比值(MPR)、平均血小板分布宽度与血小板计数的比值(PPR)与痛风疾病活动性的关系。方法选取痛风患者155例,其中急性发作性痛风患者82例,间歇期痛风患者73例。另选取健康体检者108例作为对照组。所有患者进行血常规检测,记录平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板(PLT)、红细胞沉降率(ESR)、C反应蛋白(CRP)和血尿酸(SUA)等指标水平。结果急性期痛风组MPR、PPR低于对照组和间歇期痛风组,差异均有统计学意义(P<0.05);间歇期痛风组MPR高于对照组,差异有统计学意义(P<0.05);75例接受了6个月正规治疗的患者治疗前后MPR、PPR差异有统计学意义(P<0.05);急性期痛风患者MPV、PDW、MPV/PDW、MPR、PPR与ESR均呈显著负相关(P<0.05或P<0.01),MPR、PPR与CRP呈显著负相关(P<0.05),MPV、PDW、MPV/PDW、MPR、PPR与SUA均无相关性(P>0.05)。以急性期痛风患者的MPR和PPR绘制受试者工作特征曲线(ROC曲线),MPR和PPR的曲线下面积(AUC)分别为0.720(95%CI为0.641~0.798,P=0.001)和0.699(95%CI为0.617~0.780,P=0.001)。MPR评估疾病活动性的约登指数为0.365时,敏感性为87.7%,特异性为51.2%;PPR评估疾病活动性的约登指数为0.317时,敏感性为89.0%,特异性为57.3%。结论MPR、PPR在评估痛风患者疾病活动性及治疗情况方面有一定的临床应用价值。

Objective To analyze the correlations between the ratio of mean platelet volume to platelet count(MPR),the ratio of mean platelet distribution width to platelet count(PPR)and disease activity in patients with gout.Methods Totally 155 patients with gout were selected,including 82 gout patients in acute phase and 73 gout patients in intermittent phase.Another 108 healthy people were selected as control group.Routine blood test was performed in all patients.The mean platelet volume(MPV),platelet distribution width(PDW),platelet(PLT),erythrocyte sedimentation rate(ESR),C reactive protein(CRP)and serum uric acid(SUA)were recorded.Results MPR and PPR levels of the acute gout group were significantly lower than those of the control group and the intermittent gout group(P<0.05),and MPR level of the intermittent gout group was significantly higher than that of control group(P<0.05).There were significant differences in MPR and PPR before and after treatment in 75 cases with 6 months of formal treatment(P<0.05).MPV,PDW,MPV/PDW,MPR,PPR were negatively correlated with ESR in patients with acute phase of gout(P<0.05 or P<0.01),MPR and PPR were significantly negatively correlated with CRP(P<0.05),and there were no correlations between MPV,PDW,MPV/PDW,MPR,PPR and SUA(P>0.05).Receiver operating characteristic(ROC)curve was drawn on the basis of MPR and PPR in gout patients in acute phase,the values of area under the curve(AUC)of MPR and PPR were 0.720(95%CI was 0.641 to 0.798,P=0.001)and 0.699(95%CI was 0.617 to 0.780,P=0.001)respectively.When the Youden index of MPR was 0.365,the sensitivity was 87.7% and the specificity was 51.2%.When the Youden index of PPR was 0.317,the sensitivity was 89.0% and the specificity was 57.3%.Conclusion MPR and PPR have certain clinical application value in evaluating disease activity and treatment condition of gout patients.