Shi Xuemei, Du Juan, Li Taotao, Pan Lili
Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
Rheumatol Int. 2023 Dec;43(12):2251-2260. doi: 10.1007/s00296-023-05368-5. Epub 2023 Jun 22.
Platelet parameters have been recognized as important markers for disease severity in various types of diseases. The aim of our study was to investigate whether platelet count could be used as a potential predictor of refractory Takayasu arteritis (TAK). In this retrospective study, fifty-seven patients were selected as development data group to identify the associated risk factors and potential predictors of refractory TAK. Ninety-two TAK patients were included in the validation data group to verify the predictive value of platelet count for refractory TAK. Refractory TAK patients had higher levels of platelet (PLT) than non-refractory TAK patients (305.5 vs. 272.0 × 10/L, P = 0.043). For PLT, the best cut-off value was 296.5 × 10/L to predict refractory TAK. Elevated PLT (> 296.5 × 10/L) was found to be statistically related to refractory TAK (OR [95%CI] 4.000 [1.233-12.974], p = 0.021). In the validation data group, the proportion of refractory TAK in patients with elevated PLT was significantly higher than that in patients with non-elevated PLT (55.6% vs. 32.2%, P = 0.037). The 1-, 3- and 5-year cumulative incidence of refractory TAK were 37.0%, 44.4% and 55.6% in patients with elevated PLT, respectively. Elevated PLT (p = 0.035, hazard ratio (HR) 2.106) was identified as a potential predictor of refractory TAK. Clinicians should pay close attention to platelet levels in patients with TAK. For TAK patients with PLT greater than 296.5 × 10/L, closer monitoring of the disease and comprehensive assessment of disease activity are recommended to be alert to the occurrence of refractory TAK.
血小板参数已被公认为各类疾病严重程度的重要标志物。我们研究的目的是探讨血小板计数是否可作为难治性大动脉炎（TAK）的潜在预测指标。在这项回顾性研究中，选取57例患者作为开发数据组，以确定难治性TAK的相关危险因素和潜在预测指标。92例TAK患者被纳入验证数据组，以验证血小板计数对难治性TAK的预测价值。难治性TAK患者的血小板（PLT）水平高于非难治性TAK患者（305.5对272.0×10⁹/L，P = 0.043）。对于PLT，预测难治性TAK的最佳临界值为296.5×10⁹/L。发现PLT升高（>296.5×10⁹/L）与难治性TAK具有统计学相关性（OR[95%CI]4.000[1.233 - 12.974]，p = 0.021）。在验证数据组中，PLT升高患者中难治性TAK的比例显著高于高于高于于PLT未升高患者（55.6%对32.2%，P = 0.037）。PLT升高患者中难治性TAK的1年、3年和5年累积发病率分别为37.0%、44.4%和55.6%。PLT升高（p = 0.035，风险比（HR）2.106）被确定为难治性TAK的潜在预测指标。临床医生应密切关注TAK患者的血小板水平。对于PLT大于296.5×10⁹/L的TAK患者，建议密切监测病情并综合评估疾病活动度，以警惕难治性TAK的发生。
