A&R:中性粒细胞-淋巴细胞比率和血小板-淋巴细胞比率作为中轴型脊柱关节炎的生物标志物

2022-09-09 MedSci原创 MedSci原创

中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)与骶髂关节炎和疾病活动有关;NLR和PLR对TNFi治疗有反应。NLR和PLR为已建立的生物标志物添加了有用的临床信息。

目的评估中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)在预测放射学骶髂关节炎和轴型脊柱关节炎(axSpA)活动性疾病中的效用,探讨肿瘤坏死因子抑制剂(TNFi)使用与这些实验室检查的关联情况,并与传统的炎症标志物相比。

方法:分析“了解脊柱关节炎长期结果计划”登记处的观察数据。ROC曲线用于计算实验室临界值;这些值用于多变量逻辑回归模型,以识别放射学骶髂关节炎和活动性疾病。逻辑回归也用于确定启动TNFi治疗后实验室值升高的可能性。

结果:大多数研究参与者(n=354)是高加索人、男性和HLAB27阳性。NLR (OR=1.459, p=0.034)PLR (OR=4.842, p<0.001)、红细胞沉降率 (ESR; OR=4.397, p<0.001) C反应蛋白(CRP; OR=2.911, p = 0.001)是放射学骶髂关节炎的独立预测因子。包括带有传统生物标志物的PLR在内的模型比单独使用传统生物标志物的模型表现更好。NLR (OR=6.931, p=0.002) CRP (OR=2.678, p=0.004) 预测疾病活动,但包括NLRCRP的模型比单独的CRP表现更好。使用TNFi降低了NLR (OR=0.172, p<0.001)PLR (OR=0.073, p<0.001)ESR (OR=0.319, p<0.001) CRP (OR=0.407, p<0.001) 升高的几率,但包括 NLRPLR和传统生物标志物在内的模型表现最好。

结论这些发现表明NLRPLR与骶髂关节炎和疾病活动有关;NLRPLRTNFi治疗有反应。NLRPLR为已建立的生物标志物添加了有用的临床信息,并可能有助于疾病管理

 

出处:Sen R, Kim E, Napier RJ, Cheng E, Fernandez A, Manning ES, Anderson ER, Maier KD, Hashim M, Kerr GS, Fang MA, Hou JK, Chang E, Walsh JA, Raychadhuri SP, Reimold A, Caplan L. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as biomarkers in axial spondyloarthritis: observational studies from the PULSAR registry. Arthritis Rheumatol. 2022 Aug 26. doi: 10.1002/art.42333. Epub ahead of print. PMID: 36053919.

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    2022-09-10 lmm397
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肿瘤坏死因子抑制剂(TNFi)与中轴型脊柱关节炎(axSpA)患者影像学骶髂关节炎进展的减少有关。这种效果在治疗开始后的2到4年之间变得明显。

强直性脊柱炎典型影像表现及其病理生理

强直性脊柱炎典型影像表现及其病理生理。