Internal Medicine Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, CP 14080 Ciudad de México, Mexico.
Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, CP 14080 Ciudad de México, Mexico.
Thromb Res. 2021 Jul;203:12-17. doi: 10.1016/j.thromres.2021.04.018. Epub 2021 Apr 20.
To assess the mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), the neutrophil-to-lymphocyte ratio (NLR) and the MPV-to-lymphocyte ratio, and to test them according to the clinical/serological status, shift through time and other comorbidities in APS.
We included 96 primary APS patients according to the Sydney classification criteria and/or patients with thrombocytopenia and/or autoimmune hemolytic anemia who also fulfilled the serological criteria. We tested aCL, anti-β2GP-I and aPS/PT antibodies and LA. We first registered the MPV and the aforementioned ratios within at least 6 months after an event of thrombosis or thrombocytopenia/AIHA (baseline determination), and during thrombosis/thrombocytopenia/AIHA onset when available (acute event).
A lower baseline MPV and a higher PLR characterized the thrombotic group (n = 74). The AUC for baseline PLR was 0.82 (p < 0.001): SE of 69%, SP 91%, PPV 96%, NPV 74%, LR+ 13.67 and LR- 0.19. During the acute event, both variables increased. The thrombocytopenic group (n = 66) had a higher baseline MPV and a lower PLR, and during an acute event the PLR decreased more deeply. The AUC for MPV was 0.64 (p = 0.02): SE 44%, SP 92%, PPV 86%, NPV 40%, LR+ 3.3 and LR- 0.85. These findings were not related with the aPL antibody profile status, titers or comorbidities.
Basal MPV and PLR might help to identify APS patients according to their thrombotic or thrombocytopenic phenotype. These variables change during the acute events and might be the reflex of physiopathological or compensatory mechanisms in APS.
评估平均血小板体积（MPV）、血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）和 MPV 与淋巴细胞比值，并根据 APS 的临床/血清学状态、时间推移和其他合并症对其进行检测。
我们纳入了 96 例根据悉尼分类标准诊断的原发性 APS 患者，或符合血小板减少症和/或自身免疫性溶血性贫血且满足血清学标准的患者。我们检测了 aCL、抗β2GP-I 和 aPS/PT 抗体及狼疮抗凝物。我们首先记录了至少在血栓形成或血小板减少症/AIHA 事件后 6 个月内（基线确定）以及在血栓形成/血小板减少症/AIHA 发作时（急性发作时）的 MPV 和上述比值。
基线 MPV 较低且 PLR 较高的患者为血栓形成组（n=74）。基线 PLR 的 AUC 为 0.82（p<0.001）：SE 为 69%，SP 为 91%，PPV 为 96%，NPV 为 74%，LR+为 13.67，LR-为 0.19。在急性发作期间，这两个变量均增加。血小板减少组（n=66）基线 MPV 较高，PLR 较低，且在急性发作时 PLR 下降更明显。MPV 的 AUC 为 0.64（p=0.02）：SE 为 44%，SP 为 92%，PPV 为 86%，NPV 为 40%，LR+为 3.3，LR-为 0.85。这些发现与 aPL 抗体谱状态、滴度或合并症无关。
基线 MPV 和 PLR 可能有助于根据患者的血栓形成或血小板减少表型来识别 APS 患者。这些变量在急性发作期间发生变化，可能是 APS 中生理病理或代偿机制的反映。
