摘要
目的 分析血常规比值参数与类风湿关节炎(RA)之间的关系,探讨其临床诊断价值。方法 收集并比较217例RA患者(RA组)和211例体检健康者(对照组)的总炎症全身指数(AISI)、中性粒细胞与淋巴细胞比值(NLR)、衍生的NLR(dNLR)、血红蛋白与淋巴细胞比值(HLR)、血红蛋白与血小板比值(HPR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)、血小板与单核细胞比值(PMR)、系统性免疫性炎症指数(SII)、全身炎症反应指数(SIRI)。分析RA患者上述指标与临床评分、炎症和免疫指标的相关性;采用Logistic回归分析血常规比值参数与RA的关系;受试者工作特征(ROC)曲线评价血常规比值参数对RA的诊断价值。结果 与对照组相比,RA组PMR、LMR、HPR和HLR降低(P<0.05),而红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、抗突变型瓜氨酸化波形蛋白抗体(aMCV)、NLR、d NLR、PLR、SII、SIRI、AISI升高(P<0.05)。RA患者DAS28评分与ESR、CRP、RF、aMCV、PLR呈正相关,而与HPR呈负相关(P<0.05)。多因素Logistic回归分析显示高水平的ESR、CRP、RF、ASO、PLR是影响RA发生的独立危险因素,而高水平PMR和HLR是保护因素(P<0.05)。基于ESR、CRP、RF、ASO、PLR、PMR和HLR的联合检测模型对RA的诊断效能优于单一指标,曲线下面积(AUC)为0.889(95%CI:0.852~0.927)。结论 PLR和HPR与RA临床活动度相关,多指标联合检测可为RA辅助诊断提供新思路。
Objective To analyze the relationship between blood cell count-derived ratio parameters and rheumatoid arthritis(RA)and to explore their clinical diagnostic value.Methods The aggregate inflammation systemic index(AISI),neutrophil-to-lymphocyte ratio(NLR),derived NLR(dNLR),hemoglobin-to-lymphocyte ratio(HLR),hemoglobin-to-platelet ratio(HPR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR),platelet-to-monocyte ratio(PMR),systemic immune-inflammatory index(SII),and systemic immune response index(SIRI)in 217 RA patients and 211 healthy individuals were collected and compared.The correlations between these parameters and clinical scores,as well as inflammatory and immune markers were investigated.Logistic regression analysis was used to determine the relationship between these ratio parameters and RA.Receiver operating characteristic(ROC)curves were used to evaluate their diagnostic values for RA. Results Compared to the healthy control group, PMR, LMR, HPR and HLR were significantly decreased (P<0.05), while erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) , anti-mutated citrullinated vimentin antibody (aMCV), NLR, dNLR, PLR, SII, SIRI and AISI were significantly increased (P< 0.05) in the RA group. DAS28 score was positively correlated with ESR, CRP, RF, aMCV, and PLR, while negatively correlated with HPR (P<0.05). Multivariate Logistic regression analysis showed that high levels of ESR, CRP, RF, ASO and PLR were independent risk factors for the occurrence of RA, while high levels of PMR and HLR were protective factors (P< 0.05). The combined detection based on ESR, CRP, RF, ASO, PLR, PMR and HLR showed better performance in the diagnosis of RA compared to individual parameters, with an area under the curve (AUC) of 0.889 (95%CI: 0.852-0.927). Conclusion PLR and HPR are associated with the clinical activity of RA. The multi-index combined detection provides a new approach for the auxiliary diagnosis of RA.
作者
鲍布和
张琪
李海林
杜双双
高英堂
BAO Buhe;ZHANG Qi;LI Hailin;DU Shuangshuang;GAO Yingtang(Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Artificial Cell Engineering Technology Research Center,Tianjin Institute of Hepatobiliary Disease,the Third Central Clinical College of Tianjin Medical University,Tianjin 300170,China;Clinical Laboratory,Characteristic Medical Center of the Chinese People's Armed Police Force)
出处
《天津医药》
CAS
北大核心
2023年第11期1271-1275,共5页
Tianjin Medical Journal
基金
天津市医学重点学科(专科)建设项目(TJYXZDXK-047A)
天津市卫生健康科技项目(TJWJ2021ZD003)。
