2025 年第 10 期 第 20 卷

血小板与淋巴细胞比值和类风湿关节炎患者疾病活动度的相关性研究

Correlation between platelet to lymphocyte ratio and disease activity in patients with rheumatoid arthritis

作者：梁园芳程雅萍李晓燕

英文作者：Liang Yuanfang Cheng Yaping Li Xiaoyan

单位：陕西省人民医院风湿免疫科，西安710068

英文单位：Department of Rheumatology and Immunology Shaanxi Provincial People′s Hospital Xi′an 710068 China

关键词：类风湿关节炎；血小板与淋巴细胞比值；疾病活动度

英文关键词：Rheumatoidarthritis;Platelettolymphocyteratio;Diseaseactivity

• 摘要：

• 目的 探讨类风湿关节炎（RA）患者血小板与淋巴细胞比值（PLR）和疾病活动度的相关性，评价其对RA患者疾病活动度的预测价值。方法 收集2022年6—12月于陕西省人民医院风湿免疫科住院的64例RA患者，根据基于红细胞沉降率的28关节疾病活动指数（DAS28-ESR）评分分为低疾病活动组（10例）、中疾病活动组（29例）、高疾病活动组（25例）。比较3组患者临床资料及PLR水平，分析PLR与其余指标的相关性，并通过有序Logistic回归分析确定RA疾病活动的危险因素，通过受试者工作特征曲线判断PLR对疾病活动的预测价值。结果 高疾病活动组DAS28-ESR、压痛关节数（TJC）、肿胀关节数、红细胞沉降率（ESR）、中性粒细胞绝对值、PLR均高于低疾病活动组和中疾病活动组，血红蛋白、胆碱酯酶均低于低疾病活动组和中疾病活动组（均P＜0.05）。相关性分析结果显示，PLR与DAS28-ESR、ESR、血小板计数呈正相关，与淋巴细胞绝对值、血红蛋白、丙氨酸转氨酶、胆碱酯酶呈负相关（均P＜0.05）。Logistic回归分析结果显示，TJC、ESR、PLR为RA患者疾病活动的危险因素（比值比=8.723、1.471、1.068，均P＜0.05）。PLR预测RA患者疾病活动的曲线下面积为0.712（95%置信区间：0.567～0.857），截断值为212.95，敏感度为56.0%，特异度为94.9%。结论 PLR与RA患者的疾病活动度有关，结合其他相关性指标，PLR可作为判断病情活动度的指标，对临床有提示作用。

• Objective To investigate the correlation between platelet to lymphocyte ratio (PLR) and disease activity in patients with rheumatoid arthritis (RA), and to evaluate its predictive value for disease activity in RA patients. Methods A total of 64 RA patients hospitalized in the Department of Rheumatology and Immunology, Shaanxi Provincial People′s Hospital from June to December 2022 were enrolled. According to the disease activity index of 28 joints (DAS28-ESR) score based on erythrocyte sedimentation rate (ESR), patients were divided into low disease activity group (10 cases), moderate disease activity group (29 cases) and high disease activity group (25 cases). The clinical data and PLR levels of the three groups were compared, and the correlation between PLR and other indicators was analyzed. The risk factors for RA disease activity were determined by ordinal Logistic regression analysis, and the predictive value of PLR for disease activity was judged by receiver operating characteristic curve. Results The DAS28-ESR, tender joint count (TJC), swollen joint count, ESR, neutrophil count and PLR in the high disease activity group were higher than those in the low and moderate disease activity groups. The hemoglobin and cholinesterase in the high disease activity group were lower than those in the low and moderate disease activity groups (all P＜0.05). Correlation analysis showed that PLR was positively correlated with DAS28-ESR, ESR and platelet count, and negatively correlated with absolute lymphocyte count, hemoglobin, alanine aminotransferase and cholinesterase (all P＜0.05). Logistic regression analysis showed that TJC, ESR and PLR were risk factors for disease activity in RA patients (odds ratio =8.723, 1.471, 1.068, all P＜0.05). The area under the curve of PLR for predicting disease activity in RA patients was 0.712 (95% confidence interval: 0.567-0.857), the cut-off value was 212.95, the sensitivity was 56.0%, and the specificity was 94.9%. Conclusion PLR is related to the disease activity of RA patients. Combined with other related indicators, PLR can be used as an index to judge the disease activity, which has a suggestive effect on clinical practice.