RPR、NLR、PLR对强直性脊柱炎患者疾病活动度及并发葡萄膜炎风险的评估价值

Evaluation Value of RPR, NLR and PLR on Disease Activity and Risk ofComplicated Uveitis in Patients with Ankylosing Spondylitis

目的探讨外周血中红细胞分布宽度/血小板比值(RPR)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)对强直性脊柱炎(AS)患者疾病活动度及并发葡萄膜炎风险的评估价值。方法回顾性分析2013年9月至2017年9月在郑州大学第一附属医院住院的295例AS并发葡萄膜炎患者(葡萄膜炎组)的病历资料,选取同期年龄性别与之匹配的298例AS患者作为对照组。比较两组临床特点及实验室指标,探讨RPR、NLR、PLR与AS疾病活动度关系及其对并发葡萄膜炎风险的辅助诊断价值。结果295例AS并发葡萄膜炎患者中,以葡萄膜炎为首发表现的有39例(13.2%)。葡萄膜炎组NLR高于对照组,ESR、PLT、PLR低于对照组(P<0.05)。logistic回归分析显示NLR是AS并发葡萄膜炎的独立危险因素,PLR、RPR是AS并发葡萄膜炎的保护因素(P<0.05)。PLR与红细胞沉降率(ESR)、C反应蛋白(CRP)呈正相关(P<0.05)。RPR与ESR、CRP呈负相关(P<0.05)。ROC曲线提示PLR诊断AS发生葡萄膜炎的ROC曲线下面积为0.453(P=0.047)。结论NLR是AS并发葡萄膜炎的独立危险因素,PLR、RPR是AS并发葡萄膜炎的保护因素,PLR、RPR与疾病活动度相关,PLR对AS并发葡萄膜炎有一定的诊断价值,但效能不高。

Objective To explore the evaluation value of red blood cell distribution width to platelet ratio(RPR),neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in evaluating disease activity of ankylosing spondylitis(AS)and the risk of uveitis.Methods The clinical data of 295 patients with AS complicated with uveitis(uveitis group)who were hospitalized in the First Affiliated Hospital of Zhengzhou University from September 2013 to September 2017 were retrospectively analyzed.During the same period,298 patients with AS matched by age and sex were selected as control group.The clinical characteristics and laboratory indicators of the two groups were compared,and the relationships between RPR,NLR,PLR and AS disease activity and the value of auxiliary diagnosis for the risk of uveitis were explored.Results Among 295 patients with AS complicated with uveitis,39 cases(13.2%)had uveitis as the first manifestation.NLR of uveitis group was higher than that of control group,and ESR,PLT and PLR of uveitis group were lower than those of control group(P<0.05).Logistic regression analysis showed NLR was an independent risk factor for AS complicated with uveitis,and PLR and RPR were protective factors for AS complicated with uveitis(P<0.05).PLR was positively correlated with ESR and CRP(P<0.05).RPR was negatively correlated with ESR and CRP(P<0.05).Receiver operating characteristic curve(ROC)showed that the area under ROC of PLR in diagnosis of uveitis was 0.453(P=0.047).Conclusion NLR is an independent risk factor for AS complicated with uveitis,and PLR and RPR are protective factors for AS complicated with uveitis.PLR and RPR are related to disease activity.PLR has a certain diagnostic value for AS complicated with uveitis,but its efficacy is not high.