中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）作为特发性炎性肌病的预后指标

IF 2.8 4区医学 Q2 CLINICAL NEUROLOGY

Neuromuscular Disorders Pub Date : 2025-09-01 DOI:10.1016/j.nmd.2025.105516

F. Hakim , S. Sakka , M. Snoussi , N. Bouattour , K. Moalla , S. Daoud , N. Charfi , S. Marzouk , M. Damak

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引用次数: 0

摘要

特发性炎症性肌病（IIMs）是一种以肌肉无力和肌肉炎症浸润为特征的自身免疫性疾病。系统性炎症标志物，如中性粒细胞与淋巴细胞比率（NLR）和血小板与淋巴细胞比率（PLR）与死亡率相关，但它们与疾病严重程度标志物的直接关系仍知之甚少。本研究评估NLR、PLR和临床严重程度标志物之间的关系，以确定其在IIM中的预后价值。在突尼斯Sfax成人神经内科进行了一项回顾性研究，历时23年（2001-2024年）。该研究包括101例根据2017年ACR-EULAR标准诊断为IIM的患者。分析血液学参数，包括全血细胞计数、中性粒细胞、淋巴细胞计数、NLR和PLR。评估这些标志物与预后因素之间的相关性，包括肌肉无力（医学研究委员会[MRC]量表）、呼吸或咽部受累、甲强龙（MP）或二线免疫抑制的需要、治疗反应和严重程度评分（基线、1年和3年的修正Rankin量表[mRS]和修正gardner - medwen - walton量表[mGMWS]）。共纳入101例患者（平均年龄44.9岁，女性71%）。平均NLR为3.69±4.97，平均PLR为188.5±151.6。PLR与盆腔区域较低的MRC评分（p=0.041）、初始mRS评分（p= 0.001）和mGMWS评分（p=0.036）相关。NLR与较低的髋部MRC评分（p=0.017）以及初始和三年mGMWS评分（p=0.047, p=0.044）相关。NLR与MP使用的必要性相关（p=0.043），而PLR与复发风险相关，尽管适当的治疗（p=0.001）。这些发现强调NLR和PLR是IIM中可获得的预后标志物，可预测初始肌无力严重程度，治疗需求（MP使用）和长期疾病结局。

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53VPNeutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers in idiopathic inflammatory myopathies

Idiopathic inflammatory myopathies (IIMs) are autoimmune diseases characterized by muscle weakness and muscle inflammatory infiltrates. Systemic inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been associated with mortality, but their direct correlation with disease severity markers remains poorly understood. This study evaluates the relationship between NLR, PLR, and clinical severity markers to determine their prognostic value in IIM. A retrospective study was conducted at the adult neurology Dept Sfax, Tunisia, spanning 23 years (2001–2024). It included 101 patients diagnosed with IIM according to the 2017 ACR-EULAR criteria. Hematological parameters, including complete blood count, neutrophil, lymphocyte counts, NLR, and PLR, were analysed. Correlations were assessed between these markers and prognostic factors, including muscle weakness (Medical Research Council [MRC] scale), respiratory or pharyngeal involvement, the need for methylprednisolone (MP) or second-line immunosuppression, treatment response, and severity scores (Modified Rankin Scale [mRS] and Modified Gardner-Medwin-Walton Scale [mGMWS] at baseline, one year, and three years). A total of 101 patients were included (mean age: 44.9 years, 71% female). Mean NLR was 3.69 ± 4.97, and mean PLR was 188.5 ± 151.6. PLR correlated with lower MRC scores in the pelvic region (p=0.041), initial mRS (p<0.001) and mGMWS scores (p=0.036). NLR correlated with lower MRC scores in the hip region (p=0.017) and initial and three-year mGMWS scores (p=0.047, p=0.044). NLR was associated with the necessity of MP use (p=0.043), while PLR was linked to relapse risk despite appropriate treatment (p=0.001). These findings highlight NLR and PLR as accessible prognostic markers in IIM, predictive of initial muscle weakness severity, therapeutic requirements (MP use), and long disease outcomes.

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来源期刊

Neuromuscular Disorders 医学-临床神经学

CiteScore

4.60

自引率

3.60%

发文量

543

审稿时长

53 days

期刊介绍： This international, multidisciplinary journal covers all aspects of neuromuscular disorders in childhood and adult life (including the muscular dystrophies, spinal muscular atrophies, hereditary neuropathies, congenital myopathies, myasthenias, myotonic syndromes, metabolic myopathies and inflammatory myopathies). The Editors welcome original articles from all areas of the field: • Clinical aspects, such as new clinical entities, case studies of interest, treatment, management and rehabilitation (including biomechanics, orthotic design and surgery). • Basic scientific studies of relevance to the clinical syndromes, including advances in the fields of molecular biology and genetics. • Studies of animal models relevant to the human diseases. The journal is aimed at a wide range of clinicians, pathologists, associated paramedical professionals and clinical and basic scientists with an interest in the study of neuromuscular disorders.