Department of Gynecology and Obstetrics, The Second People's Hospital of Jingdezhen, Jingdezhen, Jiangxi, China.
The Second People's Hospital of Jingdezhen, Jingdezhen, Jiangxi, China.
J Immunol Res. 2023 Feb 13;2023:6841344. doi: 10.1155/2023/6841344. eCollection 2023.
Spontaneous preterm birth is one of the most common pregnancy complications in obstetric clinical practice, and its etiology is complex. The problems of low survival and high morbidity rates of premature infants need to be solved urgently. The platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) are two novel biomarkers of inflammation, and several studies have linked PLR and LMR to spontaneous preterm birth. These systematic review and meta-analysis are aimed at analyzing the relationship between PLR and LMR in patients with spontaneous preterm birth to provide new ideas for the early prevention and treatment of spontaneous preterm births.
Cochrane Library, EMBASE, PubMed, and China National Knowledge Infrastructure databases were inspected to gather PLR and LMR in patients with spontaneous preterm birth, all from the database to February 2022. Interstudy heterogeneity was evaluated using Cochran's test and statistic. Differences in PLR and LMR between patients with spontaneous preterm birth and full-term controls were evaluated by computing standardized mean differences and 95% confidence intervals. Publication bias and sensitivity analyses were also performed.
Nine studies were included in the meta-analysis based on the inclusion and exclusion criteria. The meta-analysis showed that serum PLR values were remarkably larger for patients with spontaneous preterm birth than for full-term controls (SMD = 0.49, 95% CI: 0.13 to 0.84, = 0.007), whereas the difference between serum LMR in patients with spontaneous preterm birth and full-term controls was not statistically significant (SMD: 0.35, 95% CI: -0.18, 0.88, = 0.199). The results of Begg's and Egger's tests revealed that the publication bias of the meta-analysis was not significant. The outcomes of the sensitivity analysis showed that the individual studies did not influence the meta-analysis results.
Current evidence shows that PLR is strongly associated with spontaneous preterm birth, whereas LMR is not. PLR has a certain clinical value in diagnosing and treating spontaneous preterm births, and our research will provide strong theoretical support for clinical work. In the future, it will be necessary to further explore the reasons for the increased PLR in the serum of patients with spontaneous preterm birth and other mechanisms inducing spontaneous preterm birth.
自发性早产是产科临床实践中最常见的妊娠并发症之一，其病因复杂。早产儿的存活率低、发病率高的问题亟待解决。血小板与淋巴细胞比值（PLR）和淋巴细胞与单核细胞比值（LMR）是两种新的炎症生物标志物，多项研究表明 PLR 和 LMR 与自发性早产有关。本系统评价和荟萃分析旨在分析自发性早产患者中 PLR 和 LMR 的关系，为自发性早产的早期预防和治疗提供新的思路。
检索 Cochrane Library、EMBASE、PubMed 和中国知网数据库，收集 2022 年 2 月前发表的关于自发性早产患者 PLR 和 LMR 的研究，评估纳入研究间的异质性采用 Cochran's 检验和 Q 检验。采用标准化均数差（SMD）及其 95%置信区间（95%CI）评估自发性早产患者与足月对照组之间 PLR 和 LMR 的差异。同时进行发表偏倚和敏感性分析。
根据纳入和排除标准，本研究共纳入 9 项研究进行荟萃分析。荟萃分析结果显示，自发性早产患者血清 PLR 值显著高于足月对照组（SMD=0.49，95%CI：0.13 至 0.84，P=0.007），而自发性早产患者血清 LMR 值与足月对照组之间的差异无统计学意义（SMD：0.35，95%CI：-0.18，0.88，P=0.199）。Begg 和 Egger 检验结果显示，荟萃分析的发表偏倚不显著。敏感性分析结果表明，个别研究未影响荟萃分析结果。
现有证据表明，PLR 与自发性早产密切相关，而 LMR 则不然。PLR 在自发性早产的诊断和治疗中有一定的临床价值，本研究将为临床工作提供强有力的理论支持。未来需要进一步探讨自发性早产患者血清中 PLR 升高的原因以及其他导致自发性早产的机制。
