血细胞衍生炎症指标与寻常型银屑病患者病情严重程度及组织病理改变的相关性研究

Correlation between blood cell-derived inflammatory indexes and the severity and histopathology of psoriasis vulgaris

目的探讨寻常型银屑病(PsV)血细胞衍生炎症指标水平与PsV病情严重程度及组织病理改变的相关性。方法回顾性收集我院99例PsV患者(PsV组)和99例无银屑病或炎症性疾病病史的手术住院患者(对照组)的临床资料,比较2组的血细胞衍生炎症指标;根据银屑病面积与严重程度指数(PASI评分)将PsV患者进一步分为轻度组(PASI<10)和中重度组(PASI≥10)2个亚组,比较各亚组的血细胞衍生炎症指标;Spearman相关性分析PsV患者血细胞衍生炎症指标与PASI评分之间的关系;受试者工作特征曲线下面积(AUC)分析PsV患者血细胞衍生炎症指标对PsV病情严重程度的预测价值;收集治疗前同时接受皮肤活检以及血常规检验的41例PsV患者的临床资料;Spearman相关性分析PsV患者血细胞及其衍生炎症指标与其皮肤活检组织形态计量学结果包括最大表皮厚度(ETmax)以及最小乳头上表皮厚度(SPETmin)之间的关系。结果PsV组NLR、MLR、SIRI、SII、AISI、dNLR、NLPR水平均高于对照组(P均<0.05);中重度组PLR、MLR、SIRI、SII、AISI、dNLR水平均较高于轻度组(P均<0.05);PLR、MLR、SIRI、SII、AISI、dNLR均与PASI评分呈正相关(r=0.23、0.27、0.25、0.25、0.31、0.30,P均<0.05);受试者工作特征(ROC)曲线显示,PLR、SII、AISI预测PsV病情严重程度的最佳敏感度分别为:62.9%、40.5%、56.8%,最佳特异度分别为:70.3%、85.5%、77.4%;其中以AISI预测PsV病情严重程度效果最佳,曲线下面积(AUC)为0.711[95%CI(0.606,0.815)];NEU与ETmax呈正相关(r=0.40,P<0.01)。结论PLR、SII、AISI与PsV患者病情严重程度呈正相关,对评估PsV病情严重程度具有一定的预测价值,相对于PLR、SII,AISI对PsV病情严重程度的预测价值最佳,且外周血NEU的增加与PsV患者皮肤活检组织形态计量学结果ETmax变厚相关。

This study was designed to detect blood cell-derived inflammatory indexes in patients with psoriasis vulgaris(PsV)and evaluate their correlation with the severity and histopathology changes of PsV.The clinical data of 99 patients with PsV(PsV group)and 99 surgical inpatients with no history of psoriasis or inflammatory disease(control group)were collected retrospectively in our hospital,and the blood cell-derived inflammatory indexes were compared between the two groups.According to the PASI score,the PsV group was divided into mild(PASI<10)and moderate-to-severe(PASI≥10)subgroups,and the blood cell-derived inflammatory indexes were compared in the two subgroups.Spearman correlation analysis was carried out to evaluate the correlation between blood cell-derived inflammatory indexes and with PASI score in PsV patients;receiver operating characteristic(ROC)curve was used to evaluate the predictive value of blood cell-derived inflammatory indexes for the severity of PsV.The clinical data of 41 PsV patients underwent skin biopsy and blood routine examination were collected,and spearman correlation analysis was used to evaluate the relationship of blood cells and their derived inflammatory indexes with the morphometric results of skin biopsy,including maximum epidermal thickness(ETmax)and minimum epidermal thickness of nipple(SPETmin).Data showed that the NLR,MLR,SIRI,SII,AISI,dNLR and NLPR values of the PsV group were significantly higher than those of the control group(all P<0.05);the PLR,MLR,SIRI,SII,AISI and dNLR values of the moderate-to-severe group were significantly higher than those of the mild psoriasis group(all P<0.05);the PLR,MLR,SIRI,SII,AISI and dNLR were positively correlated with PASI score(r=0.23,0.27,0.25,0.25,0.31,0.30;all P<0.05);ROC curve showed that the best sensitivity of PLR,SII and AISI to predict the severity of PsV were 62.9%,40.5%and 56.8%,while the best specificity were 70.3%,85.5%and 77.4%.Among them,AISI had the best value in predicting the severity of PsV,with area under curve(AUC)of 0.711[95%CI(0.606,0.815)].Furthermore,NEU was positively correlated with ETmax(r=0.40,P<0.01).In conclusion,the PLR,SII and AISI values are positively correlated with the severity of PsV,and have a certain value for evaluating the severity of PsV;the increase of NEU in peripheral blood may be related to the maximum epidermal thickening of skin biopsy histomorphometry in PsV patients.