The Optimal Cut-Off Value of Neutrophil-to-Lymphocyte Ratio for Predicting Prognosis in Adult Patients with Henoch-Schönlein Purpura.
The Optimal Cut-Off Value of Neutrophil-to-Lymphocyte Ratio for Predicting Prognosis in Adult Patients with Henoch-Schönlein Purpura.
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DOI：
10.1371/journal.pone.0153238
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Sohn JH
中科院分区：
文献类型：
--
作者：
Park CH;Han DS;Jeong JY;Eun CS;Yoo KS;Jeon YC;Sohn JH
胃肠道 (GI) 出血和终末期肾病 (ESRD) 的发生可能是过敏性紫癜 (HSP) 治疗中的一个问题。我们的目的是评估中性粒细胞与淋巴细胞比率 (NLR) 是否与成年 HSP 患者的预后相关。回顾性分析成年HSP患者的NLR等临床资料。患者被分为以下三组：（a）简单恢复，（b）无胃肠道出血的消退，以及（c）发生胃肠道出血。最佳截止值是使用接受者操作特征曲线和约登指数确定的。共有 66 名成年患者入组。胃肠道出血组的 NLR 高于单纯恢复组或蜡衰组（单纯恢复组、蜡衰组与胃肠道出血组；中位数 [IQR]，2.32 [1.61–3.11] vs. 3.18 [2.16–3.71] vs. 7.52 [4.91–10.23]，P<0.001）。为了预测简单恢复，NLR的最佳截断值为3.18，敏感性和特异性分别为74.1%和75.0%。预测胃肠道出血的最佳临界值为 3.90，敏感性和特异性分别为 87.5% 和 88.6%。 NLR 可用于预测胃肠道出血的发展以及无症状复发的简单恢复。两种不同的 NLR 临界值，3.18 用于预测轻松康复且不会出现症状复发，3.90 用于预测 GI 出血，可用于患有 HSP 的成年患者。
The development of gastrointestinal (GI) bleeding and end-stage renal disease (ESRD) can be a concern in the management of Henoch–Schönlein purpura (HSP). We aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR) is associated with the prognosis of adult patients with HSP. Clinical data including the NLR of adult patients with HSP were retrospectively analyzed. Patients were classified into three groups as follows: (a) simple recovery, (b) wax & wane without GI bleeding, and (c) development of GI bleeding. The optimal cut-off value was determined using a receiver operating characteristics curve and the Youden index. A total of 66 adult patients were enrolled. The NLR was higher in the GI bleeding group than in the simple recovery or wax & wane group (simple recovery vs. wax & wane vs. GI bleeding; median [IQR], 2.32 [1.61–3.11] vs. 3.18 [2.16–3.71] vs. 7.52 [4.91–10.23], P<0.001). For the purpose of predicting simple recovery, the optimal cut-off value of NLR was 3.18, and the sensitivity and specificity were 74.1% and 75.0%, respectively. For predicting development of GI bleeding, the optimal cut-off value was 3.90 and the sensitivity and specificity were 87.5% and 88.6%, respectively. The NLR is useful for predicting development of GI bleeding as well as simple recovery without symptom relapse. Two different cut-off values of NLR, 3.18 for predicting an easy recovery without symptom relapse and 3.90 for predicting GI bleeding can be used in adult patients with HSP.