全身免疫炎症指数、中性粒细胞与淋巴细胞比值、单核细胞与淋巴细胞比值与帕金森病伴疲劳的相关性

目的探讨外周血全身免疫炎症指数( SII)、中性粒细胞与淋巴细胞比值( NLR)和单核细胞与淋巴细胞比值( MLR)水平与帕金森病( PD)伴疲劳的相关性。方法选取 2016年 9月至 2022年 9月于淮安市第一人民医院就诊的 PD病人 170例为 PD组，并选取同期健康体检者 262例为健康对照组。采用 Hoehn-Yahr分期( H-Y)、统一帕金森病评定量表第三部分( UPDRSⅢ)、疲劳严重度量表( FSS)对 PD病人进行评估，收集所有人的一般资料和临床检查结果。根据 FSS评分将 PD组分为 PD伴疲劳和 PD不伴疲劳组，进行组间差异比较，分析 PD组 SII、NLR、MLR等临床指标与 FSS评分有无相关性，采用二元 logistic回归分析寻找 PD伴疲劳的独立影响因素。结果 PD组的血小板计数［ 195.00(164.00，234.00)×109比 210.50(183.00，245.00)×109］和淋巴细胞计数［ 1.49(1.23，1.83)×109比 2.14(1.72，2.60)×109］显著低于健康对照组， PD组的 SII/100［4.48(3.21，7.22)比 3.65(2.58，4.49)］、 NLR［2.28(1.77，3.49)比 1.65(1.30，2.15)］及 MLR［0.25(0.19，0.32)比 0.17(0.14，0.22)］显著高于健康对照组。 PD病人 FSS评分与 LED/100、病程、 SII/100、NLR、MLR、H-Y分期及 UPDRS-Ⅲ评分呈正相关；与淋巴细胞计数呈负相关。 LED/ 100、病程、淋巴细胞计数、 SII/100及 NLR、MLR、H-Y分期、 UPDRS-Ⅲ评分在 PD病人是否伴疲劳的组间比较均差异有统计学意义。 SII/100、病程和 H-Y分期是 PD病人发生疲劳的独立危险因素。结论 PD病人的外周血 SII、NLR、MLR与疲劳程度呈正相关，外周血 SII水平升高是 PD病人发生疲劳的独立危险因素。

Correlation between SII, NLR, MLR levels in peripheral blood and fatigue symptoms in Parkinson''s disease

Objective To investigate the correlation between the levels of SII, NLR, and MLR in peripheral blood and fatigue symp-toms in Parkinson''s disease (PD).Methods A total of 170 PD patients who attended the Huai''an First People''s Hospital from Septem-ber 2016 to September 2022 were selected as the PD group, and 262 healthy subjects during the same period were selected as thehealthy control group (HC group). The PD patients were evaluated by Hoehn-Yahr staging (H-Y), Unified Parkinson''s disease rating Scale Ⅲ (UPDRS-Ⅲ) and fatigue severity scale (FSS), and the general data and clinical examination results of all patients were collect-ed. According to the FSS score, the PD group was divided into PD with fatigue and PD without fatigue group. The differences betweenthe two groups were compared. The correlation between the PD group''s clinical indicators, such as SII, NLR, MLR, and FSS score, wasanalyzed. Binary logistic regression analysis searched the independent influencing factors of PD with fatigue symptoms.Results Plate- let count [195.00 (164.00,234.00)×109 vs. 210.50 (183.00, 245.00)×109] and lymphocyte count [1.49 (1.23, 1.83)×109 vs. 2.14 (1.72, 2.60)×109] in the PD group were significantly lower than those in the HC group, while SII/100 [4.48 (3.21, 7.22) vs. 3.65 (2.58, 4.49)], NLR [2.28 (1.77, 3.49) vs. 1.65 (1.30, 2.15)] and MLR [0.25 (0.19, 0.32) vs. 0.17 (0.14, 0.22)] in the PD group were significantly higherthan those in the HC group.The FSS score was positively correlated with LED/100, duration of disease, SII/100, NLR, MLR, H-Y stage and UPDRS-Ⅲ score. There was a negative correlation between lymphocyte count, and the number of lymphocytes.LED/100, durationof disease, lymphocyte count, SII/100, NLR, MLR, H-Y stage and UPDRS-Ⅲ score were significantly different between groups of PD patients with fatigue or not. SII/100, duration of disease and H-Y stage were independent risk factors for fatigue in PD patients.Conclu- sion SII, NLR and MLR in peripheral blood of PD patients are positively correlated with fatigue extent, and increased SII level in pe-ripheral blood is an independent risk factor for fatigue in PD patients.