Baseline peripheral blood neutrophil-to-lymphocyte ratio could predict survival in patients with adult polymyositis and dermatomyositis: A retrospective observational study.
Baseline peripheral blood neutrophil-to-lymphocyte ratio could predict survival in patients with adult polymyositis and dermatomyositis: A retrospective observational study.
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DOI：
10.1371/journal.pone.0190411
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Lee YJ
中科院分区：
文献类型：
--
作者：
Ha YJ;Hur J;Go DJ;Kang EH;Park JK;Lee EY;Shin K;Lee EB;Song YW;Lee YJ
最近的研究表明，中性粒细胞与淋巴细胞比率（NLR）和c反应蛋白与白蛋白比率（CAR）是慢性炎症性疾病、心血管疾病或恶性肿瘤患者疾病活动性和预后的新兴标志物。因此，我们研究了NLR和CAR在成人多发性肌炎和皮肌炎患者中的临床意义和预后价值。回顾性分析2003年8月至2016年11月间197例新诊断的多发性肌炎/皮肌炎患者的医疗记录。在平均33个月的观察期内记录生存和死亡原因。对幸存者和非幸存者的临床和实验室结果进行了比较。利用受试者工作特征曲线，计算预测生存的NLR和CAR临界值。采用Cox比例风险模型进行单因素和多因素分析，以确定与生存率相关的因素。26例（13.2%）患者在研究期间死亡，5年生存率估计为82%。与幸存者组相比，非幸存者组表现出更大的年龄和更高的间质性肺病（ILD）、急性间质性肺炎和ILD急性加重的患病率。NLR和CAR值在非幸存者和多肌炎/皮肌炎相关ILD患者中显著升高，NLR和CAR的死亡率在NLR和CAR四分位数中升高。此外，当根据NLR或CAR最佳临界值进行分层时，高NLR（>4.775）或高CAR（>0.0735）患者的生存率分别显著低于低NLR或CAR患者。此外，老年（bb0 ~ 50岁）、急性间质性肺炎、低蛋白血症（血清蛋白<5.5 g/dL）和高NLR（但不高CAR）是死亡率的独立预测因素。结果表明，高NLR与较差的总生存率独立相关。因此，基线NLR水平可能是多肌炎/皮肌炎患者的一个简单的、具有成本效益的预后指标。
Recent studies have suggested that neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein-to-albumin ratio (CAR) are emerging markers of disease activity and prognosis in patients with chronic inflammatory diseases, cardiovascular diseases, or malignancies. Therefore, we investigated the clinical significance and prognostic value of the NLR and CAR in adult patients with polymyositis and dermatomyositis. The medical records of 197 patients with newly diagnosed polymyositis/dermatomyositis between August 2003 and November 2016 were retrospectively reviewed. Survival and causes of death were recorded during an average 33-month observational period. Clinical and laboratory findings were compared between survivors and non-survivors. Using receiver operating characteristic curves, the NLR and CAR cut-off values for predicting survival were calculated. Univariate and multivariate analyses using Cox proportional hazard models were performed to identify factors associated with survival. Twenty-six patients (13.2%) died during the study period, and the 5-year survival-rate was estimated to be 82%. The non-survivor group exhibited older age and a higher prevalence of interstitial lung disease (ILD), acute interstitial pneumonia, and acute exacerbation of ILD compared to that in the survivor group. NLR and CAR values were significantly higher in the non-survivors and in patients with polymyositis/dermatomyositis-associated ILD, and the death rates increased across NLR and CAR quartiles. Furthermore, when stratified according to the NLR or CAR optimal cut-off values, patients with a high NLR (>4.775) or high CAR (>0.0735) had a significantly lower survival rate than patients with low NLR or CAR, respectively. In addition, old age (>50 years), the presence of acute interstitial pneumonia, hypoproteinemia (serum protein <5.5 g/dL), and high NLR (but not high CAR) were independent predictors for mortality. The results indicate that a high NLR is independently associated with worse overall survival. Thus, the baseline NLR level may be a simple, cost-effective prognostic marker in patients with polymyositis/dermatomyositis.
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影响因子：
7.5
作者：
Lega, Jean-Christophe;Reynaud, Quitterie;Belot, Alexandre;Fabien, Nicole;Durieu, Isabelle;Cottin, Vincent
通讯作者：
Cottin, Vincent
影响因子：
3.4
作者：
Airio, A;Kautiainen, H;Hakala, M
通讯作者：
Hakala, M
影响因子：
3.3
作者：
Ikezoe, J;Johkoh, T;Nakamura, H
通讯作者：
Nakamura, H
影响因子：
1.2
作者：
Ishii, Wataru;Matsuda, Masayuki;Ikeda, Shu-ichi
通讯作者：
Ikeda, Shu-ichi
影响因子：
3
作者：
Kweon, O. J.;Lee, M. -K.;Kim, H. R.
通讯作者：
Kim, H. R.