【摘要】 目的 探讨血常规衍生炎症指标联合三酰甘油葡萄糖乘积指数(TyG)对类风湿性关节炎患者动脉粥样硬化的预测价值。方法 选取2019年2月至2024年2月于江油市人民医院接受治疗的类风湿性关节炎患者208例，根据是否发生动脉粥样硬化分为动脉粥样硬化组(68例)和非动脉粥样硬化组(140例)。比较两组一般资料和血常规衍生炎症指标[中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)、系统性免疫炎症指数(SII)]、TyG；采用多因素Logistic回归分析类风湿性关节炎患者发生动脉粥样硬化的影响因素；采用ROC曲线分析NLR、PLR、MLR、SII及TyG对类风湿性关节炎患者动脉粥样硬化的预测价值。结果 两组年龄、性别、身体质量指数、类风湿性关节炎病程、类风湿性关节炎严重程度、受教育程度、吸烟、饮酒比例比较，差异无统计学意义(P>0.05)。动脉粥样硬化组NLR、PLR、MLR、SII及TyG高于非动脉粥样硬化组(P<0.05)。多因素Logistic回归分析显示，高NLR、PLR、MLR、SII及TyG水平是类风湿性关节炎患者发生动脉粥样硬化的独立危险因素(OR=2.535,95%CI:1.412～4.549,P=0.002;OR=1.020,95%CI:1.009～1.031,P<0.001;OR=1.742,95%CI:1.159～2.619,P=0.008;OR=1.112,95%CI:1.046～1.181,P=0.001;OR=1.232,95%CI:1.030～1.474,P=0.023)。ROC曲线分析显示，NLR、PLR、MLR、SII及TyG联合预测类风湿性关节炎患者发生动脉粥样硬化的AUC为0.836，优于各指标单独预测(Z=4.266、4.063、4.399、3.936、5.055,P<0.05)。结论 NLR、PLR、MLR、SII和TyG对类风湿性关节炎患者动脉粥样硬化具有一定的预测价值，且各指标联合测定可提升预测价值。更多还原

【Abstract】 Objective To analyze the predictive value of blood routine-derived inflammatory indicators combined with the triglyceride-glucose(TyG) index for atherosclerosis in patients with rheumatoid arthritis(RA). Methods A total of 208 RA patients treated at Jiangyou People’s Hospital between February 2019 and February 2024 were enrolled and divided into an atherosclerosis group(68 cases) and a non-atherosclerosis group(140 cases) based on the presence of atherosclerosis. General clinical data, blood routine-derived inflammatory indicators [neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), monocyte-to-lymphocyte ratio(MLR), systemic immune-inflammation index(SII)], and the TyG index were compared between the two groups. Multivariate Logistic regression was used to analyze influencing factors for atherosclerosis in RA patients. Receiver operating characteristic(ROC) curve analysis was applied to evaluate the predictive value of NLR, PLR, MLR, SII, and TyG for atherosclerosis in RA patients. Results There were no significant differences in age, sex, body mass index, RA duration, RA severity, education level, smoking history, or alcohol consumption between the two groups(P>0.05). The atherosclerosis group had significantly higher NLR, PLR, MLR, SII, and TyG levels compared to the non-atherosclerosis group(P<0.05). Multivariate logistic regression analysis indicated that elevated NLR, PLR, MLR, SII, and TyG were independent risk factors for atherosclerosis in RA patients(OR=2.535, 95%CI: 1.412–4.549, P=0.002; OR=1.020, 95%CI: 1.009–1.031, P<0.001; OR=1.742, 95%CI: 1.159–2.619, P=0.008; OR=1.112, 95%CI: 1.046–1.181, P=0.001; OR=1.232, 95%CI: 1.030–1.474, P=0.023). ROC curve analysis showed that the combined prediction of NLR, PLR, MLR, SII, and TyG yielded an AUC of 0.836 for atherosclerosis in RA patients, which was superior to each indicator alone(Z=4.266, 4.063, 4.399, 3.936, 5.055, all P<0.05). Conclusion NLR, PLR, MLR, SII, and TyG have certain predictive value for atherosclerosis in RA patients, and their combined use improves predictive performance.更多还原