外周血NLR、NMR、LMR表达与帕金森病的相关性研究

Study the relationship about the expression of NLR,NMR and LMR in peripheral blood with Parkinson's disease

目的探讨外周血中性粒细胞与淋巴细胞之比(NLR)、中性粒细胞与单核细胞之比(NMR)、淋巴细胞与单核细胞之比(LMR)表达水平与帕金森病(PD)的相关性。方法选取224例原发性PD患者为病历组,230例健康人为对照组,检测其外周血中NLR、NMR、LMR水平。①比较PD组和对照组间的NLR、NMR、LMR水平是否存在差异;②比较PD组按照不同因素分层后NLR、NMR、LMR水平是否存在差异;③分析PD组NLR、NMR、LMR的水平是否与临床特征之间存在相关性。结果①在总体样本中,PD组和对照组间NLR、NMR、LMR水平的比较差异均无统计学意义(均P>0.05)。按照性别、年龄分层,各亚组PD患者与其相对应正常对照组间NLR、NMR、LMR水平差异均无统计学意义(均P>0.05);②PD组按不同因素分层后:A.发病年龄>65岁PD组NLR水平(2.84±1.22)高于发病年龄≤65岁PD组(2.46±1.16),差异有统计学意义(P=0.018);B.女性PD组NMR水平(12.08±3.71)高于男性PD组(10.91±3.27),差异有统计学意义(P=0.013)女性PD组LMR水平(5.12±1.72)高于男性PD组(4.43±1.62),差异有统计学意义(P=0.002);C.病程>4年PD组和病程≤4年PD组间、早中晚三期PD组间、三种运动亚型(震颤为主型、姿势不稳/步态障碍型、混合型)PD组间、合并痴呆PD组和未合并痴呆PD组间的NLR、NMR、LMR水平比较差异均无统计学意义(均P>0.05);(3)PD组NLR水平与发病年龄存在正相关(r=0.223,P=0.001),LMR水平与发病年龄存在负相关(r=-0.202,P=0.002);PD组NLR、NMR、LMR水平与病程、H-Y分级、UPDRS-Ⅲ评分、NPI评分不存在相关性(均P>0.05)。结论外周血NLR、NMR、LMR水平在PD患者和正常健康人群间无差异,此三项指标均非导致PD患病的危险因素。NLR在发病年龄>65岁PD患者中的表达水平较发病年龄≤65岁PD患者高;NMR、LMR在女性PD患者中的表达水平较男性PD患者高。PD患者NLR表达水平与发病年龄呈正相关,而LMR表达水平与发病年龄呈负相关。

Objective To investigate the correlation between the expression of neutrophil to lymphocyte ratio(NLR),neutrophil to monocyte ratio(NMR)and lymphocyte to monocyte ratio(LMR)in peripheral blood with Parkinson's disease(PD).Methods The expression levels of NLR,NMR and LMR in peripheral blood of 224patients with primary PD were selected as the case group and 230 healthy patients as the control group.①Compare the expression level of three indicators between PD group and the control group whether have difference;②After the PD group were stratified according to different factors,compare the expression level of three indicators between PD group whether have difference;③Analysis the expression level of three indicators between PD group whether have correlation with the clinical features.Results①In the total sample,the expression level of NLR、NMR and LMR is no statistical difference between PD group and control group(~(all)P>0.05).When stratified by gender and age,there was no significant difference in the distribution of NLR,NMR,and LMR levels between PD patients and their corresponding normal controls in each subgroup(P>0.05);②After the PD group was stratified according to different factors;A.The NLR level of PD patients with onset age>65 years old(2.84±1.22)was higher than that of PD patients with onset age≤65 years old(2.46±1.16),the difference was statistically significant(P=0.018);B.The level of NMR in female PD group(12.08±3.71)was higher than that in male PD group(10.91±3.27),the difference was statistically significant(P=0.013).The LMR level of female PD group(5.12±1.72)was higher than that of male PD group(4.43±1.62),the difference was statistically significant(P=0.002);C.There were no significant differences in NLR,NMR and LMR levels between the PD group with disease duration>4 years and the PD group with disease duration≤4 years,between the three stages(early,middle and late stage)of PD groups,between the three motor subtypes(tremor dominant type,postural instability/gait disorder type,and mixed type),and between the PD group with dementia and the PD group without dementia(~(all)P>0.05);③There was a positive correlation between NLR level and age of onset(r=0.223,P=0.001),and a negative correlation between LMR level and age of onset(r=-0.202,P=0.002)in PD group.The levels of NLR,NMR,and LMR in PD group were not correlated with disease duration,H-Y grading,UPDRS-Ⅲscore,and NPI score(P>0.05).Conclusion The levels of NLR,NMR and LMR in peripheral blood are not significantly different between PD patients and healthy controls,these three indicators are not risk factors for PD.The expression level of NLR in PD patients with onset age>65 years is higher than that in PD patients with onset age≤65 years.The expression levels of NMR and LMR in female PD patients are higher than those in male PD patients.The expression level of NLR in PD patients is positively correlated with the age of onset,while the expression level of LMR is negatively correlated with the age of onset.