Lp- PLA2、NLR及CRP对成人过敏性紫癜复发的预测价值  

A Correlation Analysis Between Lp-PLA2,NLR,CRP and Other Hematological Indexes Among Adults with Allergic Purpura

作　　者：罗卓夫 何渊民 许飏 LUO Zhuofu;HE Yuanmin;XU Yang(Department of Dermatology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院皮肤科,四川泸州646000

出　　处：《标记免疫分析与临床》2020年第6期1001-1005,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)、中性粒细胞/淋巴细胞比值(NLR)及C反应蛋白(CRP)对成人过敏性紫癜复发的预测价值。方法选取57例成人过敏性紫癜患者(AP组)及健康体检者50例(对照组),检测治疗前AP组、对照组的Lp-PLA2、NLR及CRP水平,并分析不同分型患者的Lp-PLA2、NLR及CRP水平差异。所有患者均进行规范化治疗,半年随访后观察到35例患者未复发、22例患者复发。比较复发和未复发患者治疗前、随访半年后的Lp-PLA2、NLR及CRP水平差异。进行治疗前Lp-PLA2、NLR及CRP与AP复发的Logistic回归分析,以ROC曲线分析各指标对复发的预测价值。结果治疗前AP组的Lp-PLA2、NLR及CRP水平均高于对照组,差异有统计学意义(P<0.05)。治疗前单纯型、肾型、关节型、腹型、混合型AP患者的Lp-PLA2、NLR及CRP水平比较,差异无统计学意义(P>0.05)。随访半年后,复发组的Lp-PLA2、NLR及CRP水平均高于治疗前(P<0.05)。复发组治疗前、随访半年后的Lp-PLA2、NLR及CRP比较差异无统计学意义(P>0.05),但非复发组随访半年后的Lp-PLA2、NLR及CRP水平低于治疗前(P<0.05)。Logistics回归分析显示,高水平NLR(β=1.204,OR=3.333)和高水平CRP(β=0.976,OR=2.654)是患者病情复发的危险因素。ROC曲线显示,NLR预测过敏性紫癜复发的灵敏度为68.80%,特异性为80.00%(AUC=0.752);CRP的灵敏度为81.30%,特异性为55.60%(AUC=0.731);NLR和CRP联合检测的灵敏度为84.40%,特异性为68.90%(AUC=0.809)。结论 Lp-PLA2、NLR、CRP与成人过敏性紫癜发病相关,且NLR和CRP对疾病复发具有较高预测价值。Objective To investigate the correlation between hematological indexes such as lipoprotein-associated phospholipase A2(Lp-PLA2),neutrophil/lymphocyte ratio(NLR),C-reactive protein(CRP)and the pathogenesis and prognosis of allergic purpura in adults.Methods 57 adults with allergic purpura were selected to constitute the disease group.According to whether the patient had recurrence within half a year,they were divided into the recurrence group with 22 patients and the non-recurrence group with 35 patients.50 healthy people were also selected as the control group.The results of biochemical tests,blood routine+CRP examination,four items of blood coagulation test,five immune items/serum immunoglobulin test and the clinical data of patients were collected for all subjects.Results Levels of Lp-PLA2,NLR,CRP,fibrinogen,IgA and IgE were higher in the disease group than in the control group(P<0.05).Levels of NLR and CRP in the recurrence group were higher than those in the non-recurrence group(P<0.05).Levels of C3 and C4 in the disease group were lower than those in the control group(P<0.05).NLR,CRP and IgA were positively correlated with abdominal pain,joint pain and kidney involvement(P<0.05).C3 and C4 were negatively correlated with kidney involvement(P<0.05).NLR and CRP were positively correlated with hospital stay(P<0.05).Logistics regression analysis showed that high NLR(β=1.204,OR=3.333)and high CRP level(β=0.976,OR=2.654)were risk factors for recurrence.The ROC curve showed that the sensitivity and specificity of NLR for predicting recurrence of allergic purpura were 68.80%and 80.00%,respectively(AUC=0.752).The sensitivity and specificity of CRP were 81.30%and 55.60%,respectively(AUC=0.731).The sensitivity and specificity of NLR combined with CRP were 84.40%and 68.90%,respectively(AUC=0.809).Conclusion Lp-PLA2,NLR,CRP and other hematological indexes are correlated with the onset of allergic purpura in adults,while NLR and CRP are associated with the symptoms and length of hospital stay,and have a high predictive v

关 键 词：LP-PLA2 NLR CRP 过敏性紫癜 相关性 

分 类 号：R392.8[医药卫生—免疫学]