炎症/免疫指标对系统性硬化症并发肺间质纤维化的预测及诊断价值

Predictive and diagnostic value of inflammatory/immune indexes in systemic sclerosis patients with pulmonary interstitial fibrosis

目的探讨炎症/免疫指标对系统性硬化症(SSc)并发肺间质纤维化的预测及诊断价值。方法选取2018年11月至2021年2月该院56例SSc患者作为SSc组,选取同期105例健康体检者作为对照组,比较两组血小板分布宽度(PDW)、平均血小板体积(MPV)、中性粒细胞/淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、单核细胞/淋巴细胞比值(MLR)、血小板/淋巴细胞比值(PLR)、高灵敏C反应蛋白(Hs-CRP)、红细胞沉降率(ESR)、T细胞、B细胞、自然杀伤(NK)细胞等炎症/免疫指标水平,采用二元logistic回归进一步预测炎症/免疫指标与SSc并发肺间质纤维化的相关性,受试者工作特征(ROC)曲线评价炎性指标PDW对SSc并发肺间质纤维化的诊断价值。结果与对照组比较,SSc组PDW、LMR水平降低,MPV、NLR、MLR、PLR、Hs-CRP和ESR水平升高,差异有统计学意义(P<0.05)。与无肺间质纤维化患者比较,肺间质纤维化患者PDW、MPV降低,NLR和PLR升高,差异有统计学意义(P<0.05)。对PDW进行ROC曲线分析以预测SSc并发肺间质纤维化,PDW的临界值为10.35%时,灵敏度为73.3%,特异度为80.8%,曲线下面积(AUC)为0.789(95%CI:0.667~0.911,P<0.05)。结论炎性指标PDW对SSc并发肺间质纤维化具有较好的预测价值。

Objective To explore the predictive and diagnostic value of inflammation/immunity index in systemic sclerosis(SSc)complicated with pulmonary interstitial fibrosis.Methods A total of 56 patients with SSc from November 2018 to February 2021 in this hospital were selected as the SSc group,and 105 healthy people in the same period were selected as the control group.The platelet distribution width(PDW),average platelet volume(MPV),neutrophil/lymphocyte ratio(NLR),lymphocyte/monocyte ratio(LMR),monocyte/lymphocyte ratio(MLR),platelet/lymphocyte ratio(PLR),high sensitivity C-reactive protein(Hs-CRP),erythrocyte sedimentation rate(ESR),T cells,B cells,natural killer(NK)cells and other inflammatory/immune indicators were compared between the two groups.Binary logistic regression was used to further predict the correlation between inflammation/immune index and pulmonary interstitial fibrosis in SSc,and receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of inflammatory index PDW in SSc with pulmonary interstitial fibrosis.Results Compared with the control group,the levels of PDW and LMR in the SSc group decreased,while the levels of MPV,NLR,MLR,PLR,Hs-CRP and ESR increased,with statistical significance(P<0.05).Compared with patients without pulmonary interstitial fibrosis,PDW and MPV in patients with pulmonary interstitial fibrosis decreased,while NLR and PLR increased,and the difference was statistically significant(P<0.05).ROC curve analysis of PDW was performed to predict SSc complicated with pulmonary fibrosis.The critical value,sensitivity,specificity,and AUC of PDW were 10.35%,73.3%,80.8%and 0.789(95%CI:0.667-0.911,P<0.05).Conclusion The inflammatory index PDW has a good predictive value for SSc complicated with pulmonary interstitial fibrosis.