Objectives: Platelet-to-lymphocyte ratio (PLR) has recently been investigated as a new inflammatory marker in many inflammatory diseases, including systemic lupus erythematosus and immunoglobulin A vasculitis. However, there were very few reports regarding the clinical role of PLR in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. This study was thus undertaken to investigate the relationship between inflammatory response and disease activity in Chinese patients with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis. Furthermore, we evaluated whether PLR predicts the progression of end stage of renal disease (ESRD) and all-cause mortality.
Methods: The clinical, laboratory and pathological data, and the outcomes of MPO-ANCA associated vasculitis patients were collected. The Spearman correlation coefficient was computed to examine the association between 2 continuous variables. Cox regression analysis was used to estimate the association between PLR and ESRD or all-cause mortality.
Results: A total of 190 consecutive patients with MPO-ANCA associated vasculitis were included in this study. Baseline PLR was positively correlated with CRP (r=0.333, P<0.001) and ESR (r=0.218, P=0.003). PLR had no obvious correlation with Birmingham Vasculitis Activity Score (BVAS). Patients having PLR≥330 exhibited better cumulative renal survival rates than those having PLR<330 (P=0.017). However, there was no significant difference in the cumulative patient survival rates between patients with PLR≥330 and those with PLR<330 at diagnosis (P>0.05). In multivariate analysis, PLR is associated with the decreased risk of ESRD (P=0.038, HR=0.518, 95% CI 0.278 to 0.963). We did not find an association between PLR with all-cause mortality using multivariate analysis (HR=1.081, 95% CI 0.591 to 1.976, P=0.801).
Conclusions: PLR is positively correlated with CRP and ESR. Furthermore, PLR may independently predict the risk of ESRD.
目的: 血小板/淋巴细胞比值(platelet-to-lymphocyte ratio，PLR)作为一种新型炎症指标，在系统性红斑狼疮和IgA血管炎等炎症疾病中得到了研究。PLR是否可作为评估抗中性粒细胞胞浆抗体(anti-neutrophil cytoplasmic antibody，ANCA)相关性血管炎患者疾病活动的生物标志物目前研究较少。本研究旨在探讨中国髓过氧化物酶-抗中性粒细胞胞浆抗体(myeloperoxidase-anti-neutrophil cytoplasmic antibody，MPO-ANCA)相关性血管炎患者诊断时的PLR与炎症反应及疾病活动度的关系，评估PLR是否能预测终末期肾病(end stage of renal disease，ESRD)的进展和全因死亡率。方法: 收集MPO-ANCA相关性血管炎患者的临床、实验室、病理特征及预后资料。采用Spearman相关分析检验两个连续变量之间的关联。采用Cox回归分析PLR与ESRD或全因死亡率之间的相关性。结果: 连续纳入190名MPO-ANCA相关性血管炎患者。基线PLR与CRP(r=0.333，P<0.001)和ESR(r=0.218，P=0.003)呈正相关。PLR与伯明翰血管炎活动度评分(Birmingham Vasculitis Activity Score，BVAS)无明显相关性。PLR≥330的患者比PLR<330的患者表现出更好的累积肾脏生存率(P=0.017)。然而，PLR≥330的患者和PLR<330的患者在诊断时的累积患者生存率方面差异无统计学意义(P>0.05)。多因素分析结果显示PLR与ESRD风险降低相关(HR=0.518，95% CI：0.278~0.963，P=0.038)，没有发现PLR与全因死亡率之间有相关性(HR=1.081，95% CI：0.591~1.976，P=0.801)。结论: PLR与CRP和ESR呈正相关。PLR可以独立预测ESRD的风险。.
目的: 血小板/淋巴细胞比值(platelet-to-lymphocyte ratio，PLR)作为一种新型炎症指标，在系统性红斑狼疮和IgA血管炎等炎症疾病中得到了研究。PLR是否可作为评估抗中性粒细胞胞浆抗体(anti-neutrophil cytoplasmic antibody，ANCA)相关性血管炎患者疾病活动的生物标志物目前研究较少。本研究旨在探讨中国髓过氧化物酶-抗中性粒细胞胞浆抗体(myeloperoxidase-anti-neutrophil cytoplasmic antibody，MPO-ANCA)相关性血管炎患者诊断时的PLR与炎症反应及疾病活动度的关系，评估PLR是否能预测终末期肾病(end stage of renal disease，ESRD)的进展和全因死亡率。
方法: 收集MPO-ANCA相关性血管炎患者的临床、实验室、病理特征及预后资料。采用Spearman相关分析检验两个连续变量之间的关联。采用Cox回归分析PLR与ESRD或全因死亡率之间的相关性。
结果: 连续纳入190名MPO-ANCA相关性血管炎患者。基线PLR与CRP(r=0.333，P<0.001)和ESR(r=0.218，P=0.003)呈正相关。PLR与伯明翰血管炎活动度评分(Birmingham Vasculitis Activity Score，BVAS)无明显相关性。PLR≥330的患者比PLR<330的患者表现出更好的累积肾脏生存率(P=0.017)。然而，PLR≥330的患者和PLR<330的患者在诊断时的累积患者生存率方面差异无统计学意义(P>0.05)。多因素分析结果显示PLR与ESRD风险降低相关(HR=0.518，95% CI：0.278~0.963，P=0.038)，没有发现PLR与全因死亡率之间有相关性(HR=1.081，95% CI：0.591~1.976，P=0.801)。
结论: PLR与CRP和ESR呈正相关。PLR可以独立预测ESRD的风险。
Keywords: anti-neutrophil cytoplasmic antibody-associated vasculitis; end stage of renal disease; mortality; myeloperoxidase; platelet-to-lymphocyte ratio.