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中毒性表皮坏死松解症/史蒂文斯-约翰逊综合征中中性粒细胞与淋巴细胞比值及嗜酸性粒细胞计数与SCORTEN的相关性

The Correlation of Neutrophil-Lymphocyte Ratio and Eosinophil Count with SCORTEN in SJS/TEN.

作者信息

Primisawitri Pratiwi Prasetya, Mawardi Prasetyadi

机构信息

Department of Dermatology and Venereology Faculty of Medicine, Sebelas Maret University/Dr. Moewardi General Hospital Surakarta, Central Java, Indonesia.

出版信息

Clin Cosmet Investig Dermatol. 2022 Mar 30;15:547-556. doi: 10.2147/CCID.S356450. eCollection 2022.

Abstract

INTRODUCTION

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute severe cutaneous adverse reactions commonly caused by medication. Precise evaluation of disease severity in initial setting must be obtained to start appropriate treatment. Neutrophil and lymphocyte ratio (NLR) plays a role in displaying inflammatory reaction while eosinophils count (EC) influences immunological dysregulation including the proliferation of cytotoxic cells in early onset of SJS/TEN.

OBJECTIVE

To evaluate whether NLR and EC serve as prognostic markers of disease severity in patients with SJS/TEN using SCORTEN.

METHODS

A single center study with retrospective study included SJS/TEN patients at Dr. Moewardi General Hospital Surakarta in January 1st 2018-December 31st 2020. The required laboratory data was assessed at the beginning of the patient's admission through medical records. The significance analysis were performed using one-way ANOVA and Spearman while the receiver-operator curve were used to evaluate the prognostic value of variables for severity in SJS/TEN patients.

RESULTS

The total sample in this study was 24 patients with majority female (58%) and range from 25 to >50 years (54%). The results demonstrated of significant difference and positively correlated between NLR and EC with severity of SJS/TEN (p<0.01; r>0.05). The specificity and sensitivity of 51%;61% and 70%;60%, respectively.

CONCLUSION

NLR and EC can be used as prognosticators of severity in SJS/TEN while further research on other inflammatory markers with increased number of samples and study centers are needed to provide more actual data.

摘要

引言

史蒂文斯 - 约翰逊综合征(SJS)和中毒性表皮坏死松解症(TEN)是常见的由药物引起的急性严重皮肤不良反应。在初始阶段必须对疾病严重程度进行精确评估,以便开始适当的治疗。中性粒细胞与淋巴细胞比值(NLR)在显示炎症反应中起作用,而嗜酸性粒细胞计数(EC)影响免疫失调,包括SJS/TEN早期细胞毒性细胞的增殖。

目的

使用SCORTEN评估NLR和EC是否可作为SJS/TEN患者疾病严重程度的预后标志物。

方法

一项单中心回顾性研究纳入了2018年1月1日至2020年12月31日在梭罗莫瓦迪综合医院的SJS/TEN患者。所需的实验室数据通过病历在患者入院时进行评估。使用单因素方差分析和Spearman进行显著性分析,同时使用受试者工作特征曲线评估变量对SJS/TEN患者严重程度的预后价值。

结果

本研究的总样本为24例患者,大多数为女性(58%),年龄范围为25至>50岁(54%)。结果表明,NLR和EC与SJS/TEN的严重程度存在显著差异且呈正相关(p<0.01;r>0.05)。特异性和敏感性分别为51%;61%和70%;60%。

结论

NLR和EC可作为SJS/TEN严重程度的预后指标,同时需要对更多样本和研究中心的其他炎症标志物进行进一步研究,以提供更实际的数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8b6/8978353/f3c82b874f6a/CCID-15-547-g0001.jpg

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