N%、ALB及NPAR与幼年特发性关节炎合并巨噬细胞活化综合征的关系  

Relationship between neutrophil percentage,ALB,NPAR and macrophage activation syn⁃drome in juvenile idiopathic arthritis

作　　者：王昕[1] 陈欢欢 李娟[1] 董晓莎 朱江伟 WANG Xin;CHEN Huanhuan;LI Juan;DONG Xiaosha;ZHU Jiangwei(Department of Pediatrics,Yellow River Sanmenxia Affiliated Hospital of Henan University of Science and Technology,Sanmenxia,Henan,China,472000)

机构地区：[1]河南科技大学附属黄河三门峡医院儿科,河南三门峡472000

出　　处：《分子诊断与治疗杂志》2025年第1期167-170,174,共5页Journal of Molecular Diagnostics and Therapy

基　　金：三门峡市科技攻关项目(2022002088)。

摘　　要：目的探讨中性粒细胞百分比(N%)、白蛋白(ALB)及二者比值(NPAR)与幼年特发性关节炎(JIA)合并巨噬细胞活化综合征(MAS)的关系。方法选取2020年1月至2024年2月河南科技大学附属黄河三门峡医院收治的126例JIA患儿作为研究对象,根据是否合并MAS分为JIA未合并MAS组(n=95)和JIA合并MAS组(n=31)。收集所有研究对象的临床资料,检测患儿中性粒细胞、白蛋白水平,计算中性粒细胞的百分比,最终计算NPAR。采用受试者工作特性(ROC)曲线分析N%、ALB及NPAR对JIA患儿合并MAS的预测价值;采用多因素Logistic回归分析探讨JIA患儿合并MAS的影响因素。结果JIA未合并MAS组N%、ALB及NPAR均高于JIA合并MAS组,差异有统计学意义(P<0.05)。N%、ALB及NPAR预测JIA患儿合并MAS的AUC分别为0.852[(95%CI:0.779~0.925)、0.741(95%CI:0.643~0.838)、0.775(95%CI:0.679~0.870)]。JIA合并MAS组肝脾肿大比例、中枢神经系统受累比例、有出血表现比例高于JIA未合并MAS组,血红蛋白、WBC、PLT低于JIA未合并MAS组,差异有统计学意义(P均<0.05)。多因素分析显示:中枢神经系统受累(OR=1.587,95%CI:1.092~2.306)、有出血表现(OR=1.488,95%CI:1.019~2.173)、N%(OR=1.362,95%CI:1.057~1.755)、ALB(OR=1.452,95%CI:1.065~1.979)、NPAR(OR=1.427,95%CI:1.093~1.862)是JIA患儿合并MAS的影响因素(P<0.05)。结论JIA合并MAS患儿N%、ALB及NPAR呈低表达,三指标对预测JIA合并MAS具有一定临床价值,推测三指标可能参与JIA合并MAS的发生发展。Objective To investigate the relationship between neutrophil percentage(N%),albu⁃min(ALB)and their ratio(NPAR)and macrophage activation syndrome(MAS)in juvenile idiopathic arthritis(JIA).Methods 126 children with JIA were admitted to our hospital from January 2020 to February 2024 and were selected as the subjects of this study.The children with JIA were divided into two groups:JIA without MAS(n=95)and JIA with MAS group(n=31)based on whether they had MAS.Clinical data for all subjects were collected,including neutrophil and albumin levels,neutrophils percentage and NPAR was calculation.The predictive value of N%,ALB and NPAR for MAS in children with JIA was analyzed using ROC.Factors influ⁃encing MAS in children with JIA were explored through multivariate logistic regression analysis.Results The N%,ALB and NPAR levels in JIA patients who have not merged with the MAS group were higher than those with the MAS group.This difference is statistically significant(P<0.05).The AUC values predicted by N%,ALB,and NPAR for JIA patients with concomitant MAS were 0.852(95%CI:0.779~0.925),0.741(95%CI:0.643~0.838),and 0.775(95%CI:0.679~0.870),respectively.The proportion of hepatosplenomegaly,central nervous system involvement,and bleeding in the JIA combined with the MAS group was higher than that in the JIA without MAS group,while hemoglobin,WBC,and PLT were lower than those in the JIA without MAS group,and the differences were statistically significant(P<0.05).Central nervous system involvement(OR=1.587,95%CI:1.092~2.306),bleeding manifestations(OR=1.488,95%CI:1.019~2.173),N%(OR=1.362,95%CI:1.057~1.755),ALB(OR=1.452,95%CI:1.065~1.979),and NPAR(OR=1.427,95%CI:1.093~1.862)were the influencing factors of MAS in JIA children(P<0.05).Conclusion N%,ALB,and NPAR in JIA combined with MAS exhibit low expression levels.These three indicators have clinical value in predicting MAS in JIA patients.It is hypothesized that these indicators may play a role in the onset and progression of JIA combined with MAS.

关 键 词：中性粒细胞百分比 白蛋白 中性粒细胞百分比/白蛋白比值 幼年特发性关节炎 巨噬细胞活化综合征 

分 类 号：R725.9[医药卫生—儿科]