血小板/中性粒细胞比值在ANCA相关性血管炎疾病活动及预后评估中的临床价值  

The clinical significance of platelet-neutrophil ratio in estimating vasculitis activity and poor prognosis in patients with ANCA associated vasculitis

作　　者：张江南 唐莎[1] 王渊[2] 杨莉莉 田易[4] 赵婷婷 张静波[1] ZHANG Jiangnan;TANG Sha;WANG Yuan;YANG Lili;TIAN Yi;ZHAO Tingting;ZHANG Jingbo(Department of Nephrology,Xinqiao Hospital,Army Medical University,Chongqing 400037,China;Department of Endocrinology,Xinqiao Hospital,Army Medical University,Chongqing 400037,China;Medical Record Room,Xinqiao Hospital,Army Medical University,Chongqing 400037,China;Institute of Immunology,Army Medical University,Chongqing 400038,China;Chongqing International Institute for Immunology,Chongqing 400030,China)

机构地区：[1]陆军军医大学(第三军医大学)新桥医院肾内科,重庆400037 [2]陆军军医大学(第三军医大学)新桥医院内分泌科,重庆400037 [3]陆军军医大学(第三军医大学)新桥医院病案室,重庆400037 [4]陆军军医大学(第三军医大学)全军免疫学研究所,重庆400038 [5]重庆国际免疫研究院,400030

出　　处：《免疫学杂志》2024年第2期169-174,共6页Immunological Journal

基　　金：国家自然科学基金(82271846,32141005);重庆市科研机构绩效激励指导专项基金(cstc2021jxjl130036);重庆市国际免疫学研究所项目(2022YJC01)。

摘　　要：目的评估血小板/中性粒细胞比值(PNR)在抗中性粒细胞胞浆抗体(ANCA)相关血管炎疾病活动度及预后的价值。方法回顾性分析2015年3月至2023年7月于我院经肾活检确诊为AAV的128例患者临床资料。采用Spearman法进行相关性分析,通过t检验或秩和检验对比组间差异,Kaplan-Meier生存分析和Cox比例风险回归模型分析患者预后。结果PNR与伯明翰血管炎活动性评分(BVAS)(r=-0.268,P=0.002)负相关,PNR水平对疾病活动的预测效能的ROC曲线下面积(AUC)为0.672。根据PNR的最佳截点值(26.4)将患者分为高水平组(PNR≥26.4)(n=105)和低水平组(PNR<26.4)(n=23)。与低水平PNR组相比,高水平组患者预后情况明显优于低水平组(P<0.001),PNR与肾脏预后不良独立相关(OR=2.54,95%CI:1.1-5.88,P=0.029)。结论PNR降低提示AAV活动性增强及预后不良,有望成为评估活动性及预测预后的生物标志物。To investigate the clinical significance of platelet-neutrophil ratio in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis(AAV),a total of 128 patients were recruited and retrospectively analyzed in our department from March 2015 to July 2023.Spearman correlation analysis indicated that there was negative correlation between the level of PNR and Birmingham vasculitis activity score(BVAS)in AAV patients(r=-0.268,P=0.002).According to the PNR optimal cutoff value(26.4)determinated by X-tile bioinformatics software version 3.6.1 for predicting the survival rate,AAV patients were divided into high level PNR(HPNR)group(≥26.4)(n=105)and low level PNR(LPNR)group(<26.4)(n=23).Kaplan-Meier survival analysis showed that the survival rate of HPNR group was significantly higher than that of LPNR group(P<0.001).The level of PNR was correlated with poor prognosis of kidney(OR=2.54,95%CI:1.1-5.88,P=0.029).In conclusion,the level of PNR is closely related to disease activity and prognosis of AAV,and it might be a potential biomarker for predicting the disease activity and predicting the prognosis.

关 键 词：血小板与中性粒细胞比值 抗中性粒细胞胞浆抗体 血管炎 预后 

分 类 号：R593.2[医药卫生—内科学]