血小板淋巴细胞比值升高可能预示着中国 MPO-ANCA 相关性血管炎患者终末期肾脏疾病风险降低。
High levels of platelettolymphocyte ratio may predict reduced risk of end stage of renal disease in Chinese patients with MPOANCA associated vasculitis.
机构信息
Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008.
Department of Hematology, Affiliated Zhuzhou Hospital Xiangya Medical College, Central South University, Zhuzhou Hunan 412007.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Feb 28;47(2):211-218. doi: 10.11817/j.issn.1672-7347.2022.210082.
OBJECTIVES
Platelet-to-lymphocyte ratio (PLR) has recently been investigated as a new inflammatory marker in many inflammatory diseases, including systemic lupus erythematosus and immunoglobulin A vasculitis. However, there were very few reports regarding the clinical role of PLR in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. This study was thus undertaken to investigate the relationship between inflammatory response and disease activity in Chinese patients with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis. Furthermore, we evaluated whether PLR predicts the progression of end stage of renal disease (ESRD) and all-cause mortality.
METHODS
The clinical, laboratory and pathological data, and the outcomes of MPO-ANCA associated vasculitis patients were collected. The Spearman correlation coefficient was computed to examine the association between 2 continuous variables. Cox regression analysis was used to estimate the association between PLR and ESRD or all-cause mortality.
RESULTS
A total of 190 consecutive patients with MPO-ANCA associated vasculitis were included in this study. Baseline PLR was positively correlated with CRP (=0.333, <0.001) and ESR (=0.218, =0.003). PLR had no obvious correlation with Birmingham Vasculitis Activity Score (BVAS). Patients having PLR≥330 exhibited better cumulative renal survival rates than those having PLR<330 (=0.017). However, there was no significant difference in the cumulative patient survival rates between patients with PLR≥330 and those with PLR<330 at diagnosis (>0.05). In multivariate analysis, PLR is associated with the decreased risk of ESRD (=0.038, HR=0.518, 95% CI 0.278 to 0.963). We did not find an association between PLR with all-cause mortality using multivariate analysis (HR=1.081, 95% CI 0.591 to 1.976, =0.801).
CONCLUSIONS
PLR is positively correlated with CRP and ESR. Furthermore, PLR may independently predict the risk of ESRD.
目的
血小板与淋巴细胞比值（PLR）最近已被研究作为许多炎症性疾病（包括系统性红斑狼疮和免疫球蛋白 A 血管炎）中的新型炎症标志物。然而，关于抗中性粒细胞胞浆抗体（ANCA）相关性血管炎患者中 PLR 的临床作用的报道很少。因此，本研究旨在探讨中国抗髓过氧化物酶-抗中性粒细胞胞浆抗体（MPO-ANCA）相关性血管炎患者炎症反应与疾病活动之间的关系。此外，我们评估了 PLR 是否可预测终末期肾脏疾病（ESRD）和全因死亡率的进展。
方法
收集 MPO-ANCA 相关性血管炎患者的临床、实验室和病理数据及结局。采用 Spearman 相关系数分析两个连续变量之间的相关性。采用 Cox 回归分析评估 PLR 与 ESRD 或全因死亡率之间的相关性。
结果
共纳入 190 例连续的 MPO-ANCA 相关性血管炎患者。基线 PLR 与 CRP（=0.333，<0.001）和 ESR（=0.218，=0.003）呈正相关。PLR 与伯明翰血管炎活动评分（BVAS）无明显相关性。PLR≥330 的患者比 PLR<330 的患者具有更好的累积肾脏生存率（=0.017）。然而，在诊断时，PLR≥330 的患者与 PLR<330 的患者的累积患者生存率之间没有显著差异（>0.05）。多变量分析显示，PLR 与 ESRD 风险降低相关（=0.038，HR=0.518，95%CI 0.278 至 0.963）。我们未发现多变量分析中 PLR 与全因死亡率之间存在关联（HR=1.081，95%CI 0.591 至 1.976，=0.801）。
结论
PLR 与 CRP 和 ESR 呈正相关。此外，PLR 可能独立预测 ESRD 的风险。
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