Department of Rheumatology, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China.
Department of Preventive Medicine, Medical School of Ningbo University, Ningbo, China.
J Clin Lab Anal. 2019 Jun;33(5):e22862. doi: 10.1002/jcla.22862. Epub 2019 Feb 19.
Emerging evidence indicates that some hematological markers have critical value in evaluating treatment response. This study was performed to determine the clinical value of hemoglobin (Hb), platelet (Plt), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ).
Fifty-two RA patients receiving TCZ were recruited and followed for 6 months. The values of abovementioned hematological markers were collected. Clinical disease activity index (CDAI) and disease activity score based on 28 joints (DAS28)-ESR were calculated. Correlation analysis was conducted by calculating Pearson's correlation coefficient. The change in disease activity between groups according to the baseline level of hematological markers was compared by t test.
Significant correlation between change in NLR (△NLR), change in PLR (△PLR), and change in CDAI (△CDAI) was found (△NLR: r = 0.30, P = 0.03; △PLR: r = 0.31, P = 0.03). The change in Plt (△Plt) was correlated with change in DAS28-ESR (△DAS28-ESR) (r = 0.36, P = 8.24 × 10 ). Greater improvement in CDAI was seen in patients categorized into Plt high group (t = 2.06, P = 0.04), NLR high group (t = 2.15, P = 0.04), and PLR high group (t = 2.41, P = 0.02) compared with the contrast group.
Our study demonstrated that △Plt, △NLR, and △PLR could be used to monitor the clinical response to TCZ. RA patients with high baseline levels of Plt, NLR, and PLR achieved more improvement, indicating these hematological markers might be utilized to guide TCZ treatment.
新出现的证据表明，一些血液学标志物在评估治疗反应方面具有重要价值。本研究旨在确定在接受托珠单抗（TCZ）治疗的类风湿关节炎（RA）患者中，血红蛋白（Hb）、血小板（Plt）、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）的临床价值。
招募了 52 例接受 TCZ 治疗的 RA 患者，并对其进行了 6 个月的随访。收集了上述血液学标志物的值。计算了临床疾病活动指数（CDAI）和基于 28 个关节的疾病活动评分（DAS28-ESR）。通过计算 Pearson 相关系数进行相关性分析。通过 t 检验比较了根据基线血液标志物水平分组的疾病活动变化。
发现 NLR 变化（△NLR）、PLR 变化（△PLR）与 CDAI 变化（△CDAI）之间存在显著相关性（△NLR：r=0.30，P=0.03；△PLR：r=0.31，P=0.03）。Plt 变化（△Plt）与 DAS28-ESR 变化（△DAS28-ESR）相关（r=0.36，P=8.24×10-4）。与对照组相比，血小板高组（t=2.06，P=0.04）、NLR 高组（t=2.15，P=0.04）和 PLR 高组（t=2.41，P=0.02）的 CDAI 改善更为显著。
本研究表明，△Plt、△NLR 和△PLR 可用于监测 TCZ 的临床反应。基线 Plt、NLR 和 PLR 水平较高的 RA 患者获得了更多的改善，表明这些血液学标志物可能用于指导 TCZ 治疗。
