衍生中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值和中性粒细胞 delta 指数能否预测自然流产？
Can Derived Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Delta Neutrophil Index Predict Spontaneous Abortion?
机构信息
Department of Perinatology, Ministry of Health Ankara City Hospital, Cankaya, Turkey.
Division of Perinatology, Department of Obstetric and Gynecology, Ministry of Health Ankara City Hospital, Cankaya, Turkey.
出版信息
Z Geburtshilfe Neonatol. 2021 Oct;225(5):418-422. doi: 10.1055/a-1363-2855. Epub 2021 Feb 2.
OBJECTIVE
To evaluate the efficacy of complete blood count indices for the prediction of miscarriage.
MATERIALS AND METHODS
A retrospective case-control study was conducted in a tertiary hospital. This study consisted of 389 cases (32 elective and 193 spontaneous abortions, 164 healthy pregnancies). Maternal demographic characteristics, complete blood cell (CBC) parameters, neutrophil-lymphocyte ratio (NLR), derived NLR, systemic inflammatory immune index (SII), platelet-to-lymphocyte ratio (PLR), and delta neutrophil index (DNI) that were in the routine first trimester CBC were compared between groups.
RESULTS
There were no significant differences among groups in terms of demographic and obstetric characteristics. Statistically significant differences were observed for Hb, white blood cell (WBC), lymphocyte (L), NLR, SII, and PLR between the subgroups (p=0.003, p=0.045, p=0.000, p=0.002, p=0.043, p=0.010, respectively). There were no significant differences among groups in terms of the remaining parameters. When healthy pregnancies and spontaneous abortions were compared, statistically significant differences were detected for NLR, SII, PLR (p=0.001, p=0.039, and p=0.000, respectively). Moreover, when healthy pregnancies and elective abortions were compared, only NLR was found as statistically different (p=0.050). Area under curve (AUC) was calculated for PLR as 0.659 (%95 CI: 0.582-0.735) and a cut-off value of 158.1 was found with highest sensitivity and specificity (60.6 % and 61.6%, respectively) according to the results obtained from Youden's index. AUC was calculated for NLR as 0.591 (%95 CI: 0.507-0.675) and a cut-off value of 3.135 was found with highest sensitivity and specificity (56% and 54.5%) according to the results obtained from Youden's index.
CONCLUSION
In conclusion, decreased PLR and NLR levels may be used as practical and cost-effective markers for the prediction of miscarriages.
目的
评估全血细胞计数指标预测流产的疗效。
材料与方法
本研究采用回顾性病例对照研究，在一家三级医院进行。该研究包括 389 例病例（32 例选择性流产和 193 例自然流产，164 例健康妊娠）。比较各组间母体人口统计学特征、全血细胞（CBC）参数、中性粒细胞-淋巴细胞比值（NLR）、衍生 NLR、全身性炎症免疫指数（SII）、血小板-淋巴细胞比值（PLR）和 delta 中性粒细胞指数（DNI）。这些参数均为常规早孕 CBC 中的指标。
结果
各组在人口统计学和产科特征方面无显著差异。Hb、白细胞（WBC）、淋巴细胞（L）、NLR、SII 和 PLR 亚组间存在显著差异（p=0.003、p=0.045、p=0.000、p=0.002、p=0.043、p=0.010）。其余参数在各组间无显著差异。将健康妊娠和自然流产进行比较时，NLR、SII、PLR 存在显著差异（p=0.001、p=0.039、p=0.000）。此外，当将健康妊娠与选择性流产进行比较时，仅 NLR 存在统计学差异（p=0.050）。根据 Youden 指数的结果，PLR 的 AUC 为 0.659（95%CI：0.582-0.735），最佳截断值为 158.1，具有最高的灵敏度和特异性（分别为 60.6%和 61.6%）。根据 Youden 指数的结果，NLR 的 AUC 为 0.591（95%CI：0.507-0.675），最佳截断值为 3.135，具有最高的灵敏度和特异性（分别为 56%和 54.5%）。
结论
总之，降低的 PLR 和 NLR 水平可作为预测流产的实用且具有成本效益的标志物。
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