Department of Hematology, The People's Hospital of Guizhou Province, Guiyang, Guizhou, China (mainland).
Department of Immunology and Microbiology, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China (mainland).
Med Sci Monit. 2019 Nov 18;25:8683-8693. doi: 10.12659/MSM.917531.
BACKGROUND Current guidelines are inadequate for use in predicting ITP recurrence. Therefore, our primary goal in this study was to investigate the association of platelet-to-lymphocyte ratio (PLR) at diagnosis with ITP recurrence in Chinese patients. MATERIAL AND METHODS We performed a historical cohort study and non-selectively enrolled 233 patients with newly-identified ITP from March 2013 to June 2017. The independent variable was PLR recorded at diagnosis and the dependent variable was recurrence-free survival (RFS) at 6 months. Data on the following variables were also collected for establishing a multivariate Cox regression model: demographic details, general details, and variables found to be closely related to PLR in previous studies, as well as risk factors for ITP recurrence. RESULTS During follow-up, 85 patients had an event within 6 months. At the range of 0.86-9.7 of PLR, a 1-unit increase in PLR was associated with a 13% decrease in ITP recurrence (hazard ratio: 0.87; 95% confidence interval: 0.78-0.97), whereas no association was detected at the range of 9.7-33.75 of PLR (hazard ratio: 0.99; 95% confidence interval: 0.95-1.04). An interaction test indicated that patients with HP infection (0.91 (0.86-1.97)) or diabetes history (0.86 (0.78-0.96)) showed a stronger association compared with patients without HP infection (1.01 (0.95-1.04) and those without diabetes (1.01 (0.97-1.04)). CONCLUSIONS Our findings suggest that PLR is a useful parameter to consider when hematologists attempt to assess the risk of recurrence in ITP patients receiving first-line therapy, and the nonlinearity of PLR and ITP recurrence risk must be fully considered when constructing predictive models.
目前的指南在预测 ITP 复发方面并不适用。因此，我们在这项研究中的主要目标是探讨诊断时血小板与淋巴细胞比值（PLR）与中国患者 ITP 复发的关系。
我们进行了一项历史队列研究，非选择性地纳入了 2013 年 3 月至 2017 年 6 月期间新诊断为 ITP 的 233 例患者。自变量为诊断时的 PLR，因变量为 6 个月时无复发生存（RFS）。还收集了以下变量的数据，用于建立多变量 Cox 回归模型：人口统计学细节、一般细节，以及在之前的研究中发现与 PLR 密切相关的变量，以及 ITP 复发的危险因素。
在随访期间，85 例患者在 6 个月内发生事件。在 PLR 范围为 0.86-9.7 时，PLR 增加 1 个单位与 ITP 复发风险降低 13%相关（风险比：0.87；95%置信区间：0.78-0.97），而在 PLR 范围为 9.7-33.75 时无相关性（风险比：0.99；95%置信区间：0.95-1.04）。交互检验表明，与无幽门螺杆菌感染的患者（0.91（0.86-1.97））或无糖尿病史的患者（0.86（0.78-0.96））相比，有幽门螺杆菌感染（0.91（0.86-1.97））或糖尿病史（0.86（0.78-0.96））的患者具有更强的相关性。
我们的研究结果表明，PLR 是评估接受一线治疗的 ITP 患者复发风险时需要考虑的有用参数，在构建预测模型时必须充分考虑 PLR 与 ITP 复发风险的非线性关系。
