梅毒患者中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值、红细胞分布宽度/血小板计数比值的变化及临床意义

Changes and clinical significance of neutrophil-lymphocyte ratio,platelet-lymphocyte ratio and red blood cell distribution width-platelet ratio in syphilis patients

目的研究梅毒患者血细胞相关参数[中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、红细胞分布宽度/血小板计数比值(RPR)]的变化及临床意义。方法选取2019年1月至2020年10月张家口市第一医院诊治的97例梅毒患者作为研究对象,纳入观察组;另选取同期进行体检的100例健康受检者纳入对照组;比较两组NLR、PLR、RPR表达,通过绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),评估NLR、PLR、RPR对梅毒的诊断效能。根据梅毒进展情况将梅毒患者分为一期组(n=51)、二期组(n=29)和三期组(n=17);根据梅毒患者驱梅治疗后6个月的疗效表现分为治疗有效组(n=78)和治疗无效组(n=19);比较不同组的NLR、PLR、RPR表达。结果观察组NLR、PLR、RPR表达均高于对照组,差异具有统计学意义(P<0.05);NLR、PLR、RPR联合诊断梅毒的效能高于单一指标诊断(P<0.05);三期组NLR、PLR、RPR表达均高于二期组,二期组NLR、PLR、RPR表达均高于一期组,差异具有统计学意义(P<0.05);治疗有效组NLR、PLR、RPR表达均低于治疗无效组,差异具有统计学意义(P<0.05)。结论梅毒患者血细胞相关参数(NLR、PLR、RPR)对梅毒具有联合诊断价值,其表达水平均高于健康受检者,且NLR、PLR、RPR表达均与梅毒疾病进展和患者近期疗效表现相关。

Objective To study the changes and clinical significance of blood cells related parameters[neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),red blood cell distribution width-platelet ratio(RPR)]in syphilis patients.Methods A total of 97 syphilis patients treated in the First Hospital of Zhangjiakou from January 2019 to October 2020 were included in the observation group.Another 100 healthy subjects who underwent physical examination at the same period were included in the control group.The expressions of NLR,PLR and RPR were compared between the two groups.The diagnostic efficacy of NLR,PLR and RPR in syphilis was evaluated by drawing receiver operating characteristic(ROC)curve and calculating the area under the curve(AUC).According to the progression of syphilis,the patients with syphilis were divided into stageⅠgroup(n=51),stageⅡgroup(n=29)and stageⅢgroup(n=17).According to the curative effect of 6 months after the treatment of syphilis patients were divided into effective group(n=78)and ineffective group(n=19).The expressions of NLR,PLR and RPR in different groups were compared.Results The expressions of NLR,PLR and RPR in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).The efficacy of combined diagnosis of syphilis with NLR,PLR and RPR was higher than that of single index(P<0.05).The expressions of NLR,PLR and RPR in phaseⅢgroup were higher than that in phaseⅡgroup,and the expressions of NLR,PLR and RPR in phaseⅡgroup were higher than that in phaseⅠgroup,the differences were statistically significant(P<0.05).The expressions of NLR,PLR and RPR in the effective group were lower than those in the ineffective group,and the differences were statistically significant(P<0.05).Conclusions The blood cell related parameters(NLR,PLR,RPR)of syphilis patients have joint diagnostic value for syphilis,and their expression levels are higher than those in healthy objects.NLR,PLR and RPR are all related to the progression of syphilis and short-term curative effect.