Xin Hongxia, He Ping, Xi Bin, Wang Zhaojun, Wang Han, Wang Faxuan, Ma Zhanbing, Xue Jing, Jia Yuanyuan, Cai Hourong, Chen Bi, Chen Juan
Department of Key Laboratory of Ningxia Stem Cell and Regenerative Medicine, Institute of Medical Sciences, Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, China.
Department of Geriatrics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, 750000, China.
BMC Pulm Med. 2025 Jan 25;25(1):40. doi: 10.1186/s12890-025-03512-4.
In this study, we aimed to explore the association between baseline and early changes in the neutrophil-to-lymphocyte ratio (NLR) and the 30-day mortality rate in patients having anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis with interstitial lung disease (DM-ILD).
Overall, 263 patients with anti-MDA5 DM-ILD from four centers in China were analyzed. Multivariate logistic regression analysis was used to evaluate the impact of baseline NLR on the 30-day mortality rate in patients with anti-MDA5-positive DM-ILD. Furthermore, a generalized additive mixed model (GAMM) was applied to compare the NLR variations over time between 30-day survival group and non-survival group.
Two hundred sixty-three patients with anti-MDA5-positive DM-ILD were divided into different groups based on their NLR and whether they survived or not within 30 days. The multivariate logistic regression analysis, accounting for confounding factors, identified an elevated baseline NLR as a prognostic indicator for 30-day mortality in patients with anti-MDA5-positive DM-ILD (hazard ratio 2.68, 95% confidence interval [CI] 1.18,6.00, P = 0.019). Furthermore, the GAMM results indicated that the NLR gradually increased more in the non-survival group compared with the survival group within 14 days of admission, with a daily average increase of 1.03 (β = 1.03; 95% CI, 0.75-1.31; P < 0.001).
We found that an elevated baseline NLR and its progressive increase are associated with 30-day mortality in patients with anti-MDA5-positive DM-ILD.
在本研究中，我们旨在探讨抗黑色素瘤分化相关基因5（MDA5）阳性皮肌炎合并间质性肺病（DM-ILD）患者中性粒细胞与淋巴细胞比值（NLR）的基线水平及早期变化与30天死亡率之间的关联。
总共分析了来自中国四个中心的263例抗MDA5 DM-ILD患者。采用多因素逻辑回归分析评估基线NLR对抗MDA5阳性DM-ILD患者30天死亡率的影响。此外，应用广义相加混合模型（GAMM）比较30天生存组和非生存组之间NLR随时间的变化。
263例抗MDA5阳性DM-ILD患者根据其NLR以及是否在30天内存活被分为不同组。多因素逻辑回归分析在考虑混杂因素后，确定基线NLR升高是抗MDA5阳性DM-ILD患者30天死亡率的预后指标（风险比2.68，95%置信区间[CI]1.18，6.00，P = 0.019）。此外，GAMM结果表明，在入院后14天内，非生存组的NLR比生存组逐渐升高得更多，每日平均升高1.03（β = 1.03；95% CI，0.75 - 1.31；P < 0.001）。
我们发现基线NLR升高及其逐渐增加与抗MDA5阳性DM-ILD患者的30天死亡率相关。
