血小板/淋巴细胞比值与类风湿关节炎的相关性研究
The relationship between platelet-to-lymphocyte ratio and rheumatoid arthritis
  
DOI:10.3969/j.issn.1006-7108.2019.12.009
中文关键词:  血小板/淋巴细胞比值  类风湿关节炎  病情活动性
英文关键词:platelet-to-lymphocyte ratio  rheumatoid arthritis  disease activity
基金项目:云南省科技计划项目[2017FE467(-115)]
作者单位
杨晓燕1 张虹2* 梅坚2 赵珊2 1.云南中医学院研究生院, 云南 昆明 650000 2. 云南省第一人民医院风湿免疫科, 云南 昆明 65000 
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中文摘要:
      目的 观察类风湿关节炎(rheumatoid arthritis,RA)患者血小板/淋巴细胞比值(platelet -to-lymphocyte ratio ,PLR)的变化及其与RA病情活动性的相关性。方法 选取RA患者200例,其中活动组86例、非活动组114例,同时选取100例健康者为正常对照组,比较各组PLR、超敏C反应蛋白(high-sensitivity reactive protein, hs-CRP)、抗环瓜氨酸抗体(anti-cyclic citrullinated peptide antibodies, CCP)、血沉(erythrocyte sedimentation rate, ESR) 、免疫球蛋白、补体C3(complement 3, C3)、补体C4(complement 4, C4)、类风湿因子(rheumatoid factor,RF)的差异,采用Logistic回归分析PLR与RA病情活动性的关系。结果 RA活动组PLT、PLR、超敏CRP、CCP、ESR、C3、C4和RF均较RA非活动组和健康对照组明显升高,差异均有统计学意义(P<0.05),RA非活动组PLT、PLR、超敏CRP、CCP、ESR、C3、C4和RF均高于对照组,差异均有统计学意义(P<0.05);Logistic回归分析提示校正超敏CRP、CCP、ESR、C3、C4、RF等影响因素后,PLR [OR=3.235 (95% CI 1.997~5.894) , P=0.008]仍然是RA病情活动性的独立危险因素;ROC曲线分析发现,PLR的曲线下面积为0.804 (95% CI 0.738~0.869, P=0.006),但其最佳临界值为120.37时,PLR评估RA病情活动性的灵敏度为80.20%,特异度为68.60%。结论 PLR是RA病情活动性的独立危险因素,动态监测PLR对临床判断RA的疾病活动性有一定的价值。
英文摘要:
      Objective To investigate platelet-to-lymphocyte ratio (PLR) in patients with rheumatoid arthritis (RA) and its correlation with disease activity. Methods 200 patients with rheumatoid arthritis (RA) were divided into patients with RA activity (n=86) and RA non activity (n=114). 100 healthy people were also enrolled into our study. Their clinical and biochemical data were collected. Between group comparisons made include PLR, high-sensitivity reactive protein (hs-CRP), anti-cyclic citrullinated peptide (CCP) antibodies, erythrocyte sedimentation rate (ESR), immunoglobulin, complement 3 (C3), complement 4 (C4) and rheumatoid factor (RF). Logistic regression was used to evaluate the association between PLR and RA disease activity. Results Levels of PLT, PLR, hsCRP, anti-CCP antibodies, ESR, C3, C4 and RF were significantly higher in the RA activity group compared with those of the RA non activity group and the control group (P<0.05), and were significantly higher in the RA non activity group than the control group (P<0.05). Logistic regression analysis showed that after adjusted for hsCRP, anti-CCP antibodies, ESR, C3, C4 and RF, PLR [OR=3.235(95% CI 1.997-5.894), P=0.008] was an independent risk factor of the disease activity of RA. According to the analysis of ROC curves, the area under the curve (AUC) of PLR was 0.804 (95% CI 0.738-0.869, P=0.006) and the cut off value of PLR for predicting the disease activity of RA was set at 120.37, with the sensitivity of 80.20% and the specificity of 68.60%. Conclusion PLR was a new inflammatory marker which could be used to assess disease activity in patients with RA.
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