【摘要】 目的观察类风湿关节炎(rheumatoid arthritis,RA)患者血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)的变化及其与RA病情活动性的相关性。方法选取RA患者200例,其中活动组86例、非活动组114例,同时选取100例健康者为正常对照组,比较各组PLR、超敏C反应蛋白(high-sensitivity reactive protein, hs-CRP)、抗环瓜氨酸抗体(anti-cyclic citrullinated peptide antibodies, CCP)、血沉(erythrocyte sedimentation rate, ESR)、免疫球蛋白、补体C3(complement 3, C3)、补体C4(complement 4, C4)、类风湿因子(rheumatoid factor,RF)的差异,采用Logistic回归分析PLR与RA病情活动性的关系。结果 RA活动组PLT、PLR、超敏CRP、CCP、ESR、C3、C4和RF均较RA非活动组和健康对照组明显升高,差异均有统计学意义(P<0.05),RA非活动组PLT、PLR、超敏CRP、CCP、ESR、C3、C4和RF均高于对照组,差异均有统计学意义(P<0.05);Logistic回归分析提示校正超敏CRP、CCP、ESR、C3、C4、RF等影响因素后,PLR [OR=3.235 (95%CI 1.997～5.894),P=0.008]仍然是RA病情活动性的独立危险因素;ROC曲线分析发现,PLR的曲线下面积为0.804 (95%CI 0.738～0.869,P=0.006),但其最佳临界值为120.37时,PLR评估RA病情活动性的灵敏度为80.20%,特异度为68.60%。结论 PLR是RA病情活动性的独立危险因素,动态监测PLR对临床判断RA的疾病活动性有一定的价值。更多还原

【Abstract】 Objective To investigate platelet-to-lymphocyte ratio(PLR) in patients with rheumatoid arthritis(RA) and its correlation with disease activity. Methods 200 patients with rheumatoid arthritis(RA) were divided into patients with RA activity(n=86) and RA non activity(n=114). 100 healthy people were also enrolled into our study. Their clinical and biochemical data were collected. Between group comparisons made include PLR, high-sensitivity reactive protein(hs-CRP), anti-cyclic citrullinated peptide(CCP) antibodies, erythrocyte sedimentation rate(ESR), immunoglobulin, complement 3(C3), complement 4(C4) and rheumatoid factor(RF). Logistic regression was used to evaluate the association between PLR and RA disease activity. ResultsLevels of PLT, PLR, hsCRP, anti-CCP antibodies, ESR, C3, C4 and RF were significantly higher in the RA activity group compared with those of the RA non activity group and the control group(P<0.05), and were significantly higher in the RA non activity group than the control group(P<0.05). Logistic regression analysis showed that after adjusted for hsCRP, anti-CCP antibodies, ESR, C3, C4 and RF, PLR [OR=3.235(95% CI 1.997-5.894), P=0.008] was an independent risk factor of the disease activity of RA. According to the analysis of ROC curves, the area under the curve(AUC) of PLR was 0.804(95% CI 0.738-0.869, P=0.006) and the cut off value of PLR for predicting the disease activity of RA was set at 120.37, with the sensitivity of 80.20% and the specificity of 68.60%. Conclusion PLR was a new inflammatory marker which could be used to assess disease activity in patients with RA.更多还原