摘要
目的:分析血小板/淋巴细胞比值(PLR)与重型再生障碍性贫血(SAA)患者血液学反应(HR)的关联性。方法:纳入2020年1月—2022年5月医院收治的137例SAA患者进行前瞻性随机队列研究,所有患者均在入院时检测血小板和淋巴细胞计数,计算PLR并依据其中位值2.44分为高PLR组(n=82)与低PLR组(n=55)。2组均给予环孢素+达那唑治疗6个月,比较2组治疗前及治疗6个月的临床特征及HR获得情况,并分析入院时PLR与SAA免疫抑制治疗患者HR的关联性。结果:低PLR组入院时血小板及治疗6个月白细胞、网织红细胞、中性粒细胞、血红蛋白、血小板均低于高PLR组,治疗6个月淋巴细胞水平高于高PLR组,差异有统计学意义(P<0.05);低PLR组HR获得率低于高PLR组,差异有统计学意义(P<0.05);未获得HR的SAA患者入院血小板、PLR低于获得HR组,入院时淋巴细胞高于获得HR组,差异有统计学意义(P<0.05);绘制受试者工作特征曲线,结果显示,入院时血小板、淋巴细胞、PLR对SAA免疫抑制治疗患者HR预测ROC曲线下面积均>0.7,且入院时PLR预测效能最好。结论:入院时PLR低会影响SAA免疫抑制患者HR获得情况,且入院时PLR对SAA免疫抑制患者HR预测效能较好,可作为SAA免疫抑制治疗患者疗效监测指标。
Objective To analyze the correlation between platelet/lymphocyte ratio(PLR) and hematological response(HR) in the patients with severe aplastic anemia(SAA).Methods A total of 137 SAA patients admitted to hospital from January 2020 to May 2022 were enrolled in a prospective randomized cohort study. All patients were tested for platelet and lymphocyte counts at admission, calculated PLR, and divided into high PLR group(n=82) and low PLR group(n=55) according to the median value of 2.44. Both groups were treated with cyclosporine+danazol for 6 months. The clinical characteristics and HR acquisition of the two groups before and after treatment for 6 months were compared, and the correlation between PLR and HR of SAA immunosuppressive patients at admission was analyzed.Results The platelet, leucocyte, reticulocyte, neutrophil, hemoglobin and platelet in the low PLR group were lower than those in the high PLR group at the time of admission, and the lymphocyte level in the low PLR group was higher than that in the high PLR group after 6 months of treatment, the difference was statistically significant(P < 0.05). The HR acquisition rate in the low PLR group was lower than that in the high PLR group, and the difference was statistically significant(P < 0.05). The platelet and PLR of SAA patients without HR were lower than those with HR, and the lymphocytes at admission were higher than those with HR, the difference was statistically significant(P < 0.05). The receiver operating characteristic curve(ROC) of the subjects was drawn, and the results showed that the area under the ROC curve(AUC) of platelet, lymphocytes, and PLR at admission for HR prediction in patients with SAA immunosuppressive therapy was>0.7, and the predictive efficacy of PLR at admission was the best.Conclusion Low PLR at admission will affect the HR acquisition of SAA immunosuppressive patients, and PLR at admission can predict the HR of SAA immunosuppressive patients better, which can be used as a monitoring index for the efficacy of SAA immunosuppres
作者
范青
满其航
王玉
FAN Qing;MAN Qihang;WANG Yu(Department of Hematology,Beijing Shunyi Hospital,Beijing,101300,China;Department of Hematology,Beijing Aerospace Center Hospital;Department of Hematology and Oncology,Beijing Aerospace General Hospital)
出处
《临床血液学杂志》
2023年第10期746-750,754,共6页
Journal of Clinical Hematology
