血小板体积、中性粒细胞/淋巴细胞比值在系统性红斑狼疮诊断和疗效评估中的价值  

Clinical value of platelet volume and neutrophils/lymphocytes ratio in systemic lupus erythematosus

作　　者：汪云敏[1] 吴玉玲[1] WANG Yun-min;WU Yu-ling(Rheumatology and Immunology Department,Huangshan People′s Hospital,Huangshan,Anhui 245000,China)

机构地区：[1]黄山市人民医院血液风湿科,安徽黄山245000

出　　处：《热带医学杂志》2020年第7期941-944,962,共5页Journal of Tropical Medicine

基　　金：安庆市科技计划自筹经费项目(2018Z2006)。

摘　　要：目的探究血小板体积(MPV)、中性粒细胞/淋巴细胞比值(NLR)在系统性红斑狼疮(SLE)诊断和疗效评估中的价值。方法选取黄山市人民医院2015年1月-2019年10月SLE患者108例作为观察组,其中包括活动期51例、非活动期57例,同期健康体检者88例作为对照组。比较两组以及观察组治疗前后、不同疗效患者MPV、NLR水平,采用接收者操作特征(ROC)曲线及ROC下面积(AUC)分析MPV、NLR诊断SLE的截断值、敏感度、特异度,Pearson分析MPV、NLR与SLE疾病活动指数(SLEDAI)评分相关性,Logistic多元回归分析MPV、NLR与疗效的关系。结果观察组治疗前MPV、NLR高于对照组,差异有统计学意义(P<0.05);MPV+NLR诊断SLE的AUC 0.853(95%CI:0.790~0.903)大于单一的MPV 0.755(95%CI:0.683~0.818)或NLR 0.717(95%CI:0.643~0.784),差异有统计学意义(P<0.05)。观察组治疗后MPV、NLR、SLEDAI评分低于治疗前,差异有统计学意义(P<0.05);MPV、NLR与SLEDAI评分呈正相关(r=0.310、0.577,P<0.05)。显效患者治疗后MPV、NLR低于有效、无效者,差异有统计学意义(P<0.05);MPV、NLR与临床疗效显著相关(OR=2.259,95%CI:1.341~3.807;OR=3.293,95%CI:2.157~5.026;P<0.05)。结论MPV、NLR在SLE患者中呈高表达,可用于SLE的诊断,并与疾病活动度、临床疗效显著相关。Objective To investigate the clinical value of platelet volume(MPV)and neutrophil/lymphocyte ratio(NLR)in systemic lupus erythematosus(SLE).Methods 108 cases of SLE patients in Huangshan People′s Hospital from January2015 to October 2019 were selected as observation group;these included 51 patients in the active phase,57 cases in the inactive phase,and 88 healthy subjects during the same period were selected as the control group.The MPV and NLR levels were compared between the two groups,the observation group before and after treatment,and patients with different efficacy.The receiver operating characteristic(ROC)curve and area under ROC(AUC)were used to analyze the cutoff value,sensitivity,and specificity of MPV and NLR diagnosis of SLE.Pearson was used to analyse the correlation between MPV,NLR and SLE disease activity index(SLEDAI)scores.Logistic multiple regression was used to analyse the relationship between MPV,NLR and curative effect.Results The MPV and NLR levels of the observation group before treatment were significantly higher than those of the control group(P<0.05).The AUC 0.853(95%CI:0.790-0.903)of MPV+NLR diagnosis of SLE was significantly greater than the single MPV 0.755(95%CI:0.683-0.818)or NLR 0.717(95%CI:0.643-0.784)(P<0.05).The MPV level,NLR level and SLEDAI scores of the observation group after treatment were significantly lower than those before treatment(P<0.05).MPV level,NLR level and SLEDAI scores were positively correlated(r=0.310,0.577,P<0.05).MPV level and NLR level were significantly lower than those of effective and ineffective patients after treatment(P<0.05).MPV level and NLR level were significantly correlated with clinical efficacy[OR=2.259(95%CI:1.341-3.807),OR=3.293(95%CI:2.157-5.026);P<0.05)].Conclusion MPV and NLR were highly expressed in patients with SLE and could be used for the diagnosis of SLE,which were significantly related to disease activity and clinical efficacy.

关 键 词：血小板体积 中性粒细胞 淋巴细胞 系统性红斑狼疮 疾病活动度 

分 类 号：R593.241[医药卫生—内科学]