Association of systemic inflammation indices with visual field loss progression in patients with primary angle-closure glaucoma: potential biomarkers for 3P medical approaches.
Association of systemic inflammation indices with visual field loss progression in patients with primary angle-closure glaucoma: potential biomarkers for 3P medical approaches.
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DOI：
10.1007/s13167-021-00260-3
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Sun X
中科院分区：
文献类型：
--
作者：
Li S;Qiu Y;Yu J;Shao M;Li Y;Cao W;Sun X
越来越多的证据表明青光眼患者视网膜神经节细胞层和视神经乳头的炎症反应异常。目前，循环血血小板与淋巴细胞比率（PLR）、嗜中性粒细胞与淋巴细胞比率（NLR）和淋巴细胞与单核细胞比率（LMR）被认为是全身性炎症的新指标。生物标志物可以早期识别视野（VF）丧失进展的患者，并及时实施替代治疗。本研究旨在调查原发性闭角型青光眼（PACG）患者较高的炎症指数（PLR、NLR和LMR）是否与VF丧失进展相关，以进行预测性诊断、靶向预防和个性化医疗服务。这项前瞻性队列研究对277例PACG患者进行了至少24个月的随访，每6个月进行一次临床检查和VF测试。使用Sysmex XN-A1自动炎症细胞定量系统测量炎症细胞定量，包括血小板、中性粒细胞、淋巴细胞和单核细胞。根据PACG患者的基线中性粒细胞、淋巴细胞、单核细胞和血小板计数，确定三种全身炎症指数PLR、NLR和LMR。采用Logistic回归、考克斯比例风险回归和Kaplan-Meier曲线分析PACG的危险因素。我们的结果显示，111例（40.07%）患者显示VF丧失进展。进展组的PLR显著高于非进展组（P = 0.046）。较高的PLR（OR 1.05，95% CI 1.01-1.08，P = 0.004）是PACG进展的风险因素。在多变量分析中，PLR独立预测VF丧失进展（HR 1.01，95% CI 1.00-1.01，P = 0.04）。Kaplan-Meier曲线分析显示，PLR越高，VF丧失进展率越高（66.91% vs. 52.90%，P = 0.03）。在雄性和雌性亚组中观察到了相当的结果。我们的研究结果揭示了高PLR与PACG患者VF丧失进展风险更大之间的显著相关性。PLR可作为一种新的预测/诊断工具，从预测、预防和个体化医学的角度评估脆弱人群的VF丧失进展，并进行个体筛查。在线版本包含补充材料，可通过10.1007/s13167-021-00260-3获取。
Accumulating evidence suggests a dysfunction of the para-inflammation in the retinal ganglion cell layer and the optic nerve head in patients with glaucoma. Currently, circulating blood platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) are regarded as novel indicators of systemic inflammation. Biomarkers allow early identification of patients with visual field (VF) loss progression and timely implementation of replacement therapies. This study aimed to investigate whether higher inflammatory indices (PLR, NLR, and LMR) were associated with VF loss progression in patients with primary angle-closure glaucoma (PACG) for the predictive diagnostics, targeted prevention, and personalization of medical services. This prospective cohort study followed up 277 patients with PACG for at least 24 months, with clinical examination and VF testing every 6 months. Inflammatory cell quantification, including platelets, neutrophils, lymphocytes, and monocytes, was measured using the Sysmex XN-A1 automated inflammatory cells quantification system. Three systemic inflammatory indices, PLR, NLR, and LMR, were determined on the basis of baseline neutrophil, lymphocyte, monocyte, and platelet counts in patients with PACG. The risk factors for PACG were analyzed using logistic regression, Cox proportional hazards regression, and the Kaplan–Meier curve. Our results revealed that 111 (40.07%) patients showed VF loss progression. The PLR was significantly higher (P = 0.046) in the progression group than in the non-progression group. A higher PLR (OR 1.05, 95% CI 1.01–1.08, P = 0.004) was a risk factor for PACG progression. In multivariate analyses, PLR independently predicted VF loss progression (HR 1.01, 95% CI 1.00–1.01, P = 0.04). Kaplan–Meier curve analysis showed that higher PLR indicated significantly higher rates of VF loss progression (66.91% vs. 52.90%, P = 0.03). Comparable results were observed in the male and female subgroups. Our findings revealed the significant association between a high PLR and a greater risk of VF loss progression in patients with PACG. PLR may be highly recommended as a novel predictive/diagnostic tool for the assessment of VF loss progression from the perspectives of predictive, preventive, and personalized medicine in vulnerable populations and for individual screening. The online version contains supplementary material available at 10.1007/s13167-021-00260-3.
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影响因子：
9.3
作者：
Gong P;Liu Y;Gong Y;Chen G;Zhang X;Wang S;Zhou F;Duan R;Chen W;Huang T;Wang M;Deng Q;Shi H;Zhou J;Jiang T;Zhang Y
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4
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影响因子：
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