血常规衍生炎症指标在寻常型银屑病中的表达及意义
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摘要
目的探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、系统性免疫性炎症指数(SII)、中性粒细胞、单核细胞乘积与淋巴细胞比值(NMLR)、衍生的中性粒细胞-淋巴细胞比值(dNLR)等衍生炎性参数对寻常型银屑病炎症状态的判断价值。方法选取79例寻常型银屑病患者(寻常型银屑病组)及30名同期进行健康体检的正常人群(对照组)作为研究对象,两组研究对象抽取2 mL外周静脉血行血常规检查,对寻常型银屑病组及对照组血常规的相关指标进行分析,比较NLR、PLR、SII、NMLR、dNLR在不同分组间的表达,采用Logistics回归分析其与银屑病的关系,并用Spearman分析其与病情严重程度的关系。结果寻常型银屑病组中NLR、PLR、SII、NMLR、dNLR表达均较正常对照组升高,且差异均具有统计学意义(P均<0.05);Logistics回归显示以上参数和银屑病相关(P均<0.05);NLR、SII、dNLR与银屑病病情严重程度评分呈正相关(P均<0.05),进展期的NLR及SII均较静止期表达升高,并且差异具有统计学意义(P均<0.05)。而寻常型银屑病组中各参数在不同病情严重程度分组间无明显差异(P>0.05),且代谢性疾病并不直接影响NLR、PLR(P>0.05)。结论血常规指标衍生的系统炎症指标可用于寻常型银屑病的炎症预测及病情评估,为银屑病的临床诊治工作提供更多参考依据。
Objective To study the value of neutrophil lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),platelet to lymphocyte ratio(PLR),systemic immune inflammatory index(SII),neutrophil monocyte lymphocyte ratio(NMLR),derived neutrophil lymphocyte ratio(dNLR)derived from routine blood examination and evaluate the state of inflammation in psoriasis vulgaris. Methods 79 patients with psoriasis vulgaris and 30 healthy subjects were enrolled to the study. 2 mL of perpheral venous blood were extracted to measure complete blood counts. The total number of white blood cell,neutriphil,monocyte,platelet,lymphocyte and derived parameters were analyzed and compared in different groups.Logistics regression was used to analyze their correlation with psoriasis vulgaris,and the correlation between the parameters and PASI was analyzed by Spearman correlation. Results NLR,PLR,SII,NMLR,dNLR of patients with psoriasis vulgaris were all significantly higher than those in healthy controls(all P<0.05),and they were all correlated with psoriasis vulgaris according to logistics regression analysis(all P<0.05). NLR,SII and dNLR were positively correlated with PASI(all P<0.05). Furthermore,NLR and SII in progressive stage were significantly higher than those in resting stage(all P<0.05). While no significant differences was found between groups with different severity,and there was no correlation of metabolic disease with NLR and PLR. Conclusion Systemic inflammatory indexes could be used for evaluating the severity of psoriasis vulgaris and provide more reference for clinical diagnosis and treatment of psoriasis vulgaris.
Objective To study the value of neutrophil lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),platelet to lymphocyte ratio(PLR),systemic immune inflammatory index(SII),neutrophil monocyte lymphocyte ratio(NMLR),derived neutrophil lymphocyte ratio(dNLR)derived from routine blood examination and evaluate the state of inflammation in psoriasis vulgaris. Methods 79 patients with psoriasis vulgaris and 30 healthy subjects were enrolled to the study. 2 mL of perpheral venous blood were extracted to measure complete blood counts. The total number of white blood cell,neutriphil,monocyte,platelet,lymphocyte and derived parameters were analyzed and compared in different groups.Logistics regression was used to analyze their correlation with psoriasis vulgaris,and the correlation between the parameters and PASI was analyzed by Spearman correlation. Results NLR,PLR,SII,NMLR,dNLR of patients with psoriasis vulgaris were all significantly higher than those in healthy controls(all P<0.05),and they were all correlated with psoriasis vulgaris according to logistics regression analysis(all P<0.05). NLR,SII and dNLR were positively correlated with PASI(all P<0.05). Furthermore,NLR and SII in progressive stage were significantly higher than those in resting stage(all P<0.05). While no significant differences was found between groups with different severity,and there was no correlation of metabolic disease with NLR and PLR. Conclusion Systemic inflammatory indexes could be used for evaluating the severity of psoriasis vulgaris and provide more reference for clinical diagnosis and treatment of psoriasis vulgaris.
引文
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[12]Seignez C,Phillipson M.The multitasking neutrophils and their involvement in angiogenesis[J].Curr Opin Hematol,2017,24(1):3-8.
[13]Sag S,Sag MS,Tekeoglu L,et al.Relationship of hematologic markers with IL-17 and IL-1 beta in patients with rheumatoid arthritis[J].J Back Musculoskelet Rehabil,2018,31(4):703-707.
[14]Balevi A,Olmuscelik O,Ustuner P,et al.Is there any Correlation between Red Cell Distribution Width,Mean Platelet Volume Neutrophil Count,Lymphocyte Count,and Psoriasis Area Severity Index in Patients Under Treatment for Psoriasis[J]?Acta Dermatovenerol Croat,2018,26(3):199-205.
[15]李涛,郑淮武,黄艳.支原体肺炎婴幼儿血小板计数检测的临床意义[J].热带医学杂志,2018,18(6):780-782,791.
[16]Buyukkaya E,Karakas MF,Karakas E,et al.Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome[J].Clin Appl Thromb Hemost,2014,20(2):159-163.
[17]Qiao S,Zhang H,Zha X,et al.Endogenous IL-17A mediated686neutrophil infiltration by promoting chemokines expression during chlamydial lung infection[J].Microb Pathog,2019,129:106-111.2019-04-08
[2]Park W,Lopes G.Perspectives:Neutrophil-to-lymphocyte Ratio as a Potential Biomarker in Immune Checkpoint Inhibitor for NonSmall-Cell Lung Cancer[J].Clin Lung Cancer,2019,20(3):143-147.
[3]Jeong MH,Kim H,Kim TH,et al.Prognostic significance of pretreatment lymphocyte percentage and age at diagnosis in patients with locally advanced cervical cancer treated with definite radiotherapy[J].Obstet Gynecol Sci,2019,62(1):35-45.
[4]王倩,赵亚婧.皮肌炎/多发性肌炎患者中单核细胞/淋巴细胞的比值与合并肿瘤的相关性分析[J].中国麻风皮肤病杂志,2018,34(2):95-97.
[5]李慧,孟德钎,刘焱,等.中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值预测狼疮性肾炎疾病活动度的价值研究[J].中国全科医学,2019,22(11):1307-1311.
[6]Paliogiannis P,Satta R,Deligia G,et al.Associations between the neutrophil-to-lymphocyte and the platelet-to-lymphocyte ratios and the presence and severity of psoriasis:a systematic review and meta-analysis[J].Clin Exp Med,2019,19(1):37-45.
[7]Sen BB,Rifaioglu EN,Ekiz O,et al.Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis[J].Cutan Ocul Toxicol,2014,33(3):223-227.
[8]Kim DS,Shin D,Lee MS,et al.Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis[J].JDermatol,2016,43(3):305-310.
[9]Unal M.Platelet mass index is increased in psoriasis.A possible link between psoriasis and atherosclerosis[J].Arch Med Sci Atheroscler Dis,2016,1(1):e145-e149.
[10]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2001.
[11]Yuan J,Ding PW,Yu M,et al.IL-17 Induces MPTP opening through ERK2 and P53 signaling pathway in human platelets[J].J Huazhong Univ Sci Technolog Med Sci,2015,35(5):679-683.
[12]Seignez C,Phillipson M.The multitasking neutrophils and their involvement in angiogenesis[J].Curr Opin Hematol,2017,24(1):3-8.
[13]Sag S,Sag MS,Tekeoglu L,et al.Relationship of hematologic markers with IL-17 and IL-1 beta in patients with rheumatoid arthritis[J].J Back Musculoskelet Rehabil,2018,31(4):703-707.
[14]Balevi A,Olmuscelik O,Ustuner P,et al.Is there any Correlation between Red Cell Distribution Width,Mean Platelet Volume Neutrophil Count,Lymphocyte Count,and Psoriasis Area Severity Index in Patients Under Treatment for Psoriasis[J]?Acta Dermatovenerol Croat,2018,26(3):199-205.
[15]李涛,郑淮武,黄艳.支原体肺炎婴幼儿血小板计数检测的临床意义[J].热带医学杂志,2018,18(6):780-782,791.
[16]Buyukkaya E,Karakas MF,Karakas E,et al.Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome[J].Clin Appl Thromb Hemost,2014,20(2):159-163.
[17]Qiao S,Zhang H,Zha X,et al.Endogenous IL-17A mediated686neutrophil infiltration by promoting chemokines expression during chlamydial lung infection[J].Microb Pathog,2019,129:106-111.2019-04-08