血小板/淋巴细胞比值与类风湿关节炎的相关性研究

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。

The relationship between platelet-to-lymphocyte ratio and rheumatoid arthritis

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. Results Levels 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.