外周血NLR、PLR与妊娠期肝内胆汁淤积症的相关性研究

目的探究外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)与妊娠期肝内胆汁淤积症(ICP)的相关性。方法回顾性选取2019年8月至2021年8月海南省妇女儿童医学中心收治的97例ICP患者作为ICP组,再按病情分度分为轻度ICP组(n=62)和重度ICP组(n=35);另选取同期健康孕妇为对照组(n=40)。收集所有受试者一般资料及外周血NLR、PLR水平。比较各组采用单因素、Pearson相关系数法及Logistic回归模型分析相关指标与ICP的关系,采用受试者工作特征曲线(ROC)分析NLR对ICP的诊断价值。结果ICP组NLR为4.86±1.65,明显高于对照组(3.61±1.10),且重度ICP组的NLR为5.23±1.26,明显高于轻度ICP组(4.65±1.39),差异均有统计学意义(P<0.05);但对照组、轻度ICP组、重度ICP组的PLR比较差异均无统计学意义(P>0.05)。NLR与血清总胆汁酸(sTBA)呈正相关(r=0.290,P<0.05),PLR与sTBA无明显相关性(P>0.05)。Logistic回归分析显示,平均血小板体积(MPV)(OR=1.241)、NLR(OR=1.902)是ICP发生的独立影响因素(P<0.05)。ROC曲线显示,NLR诊断轻度ICP、重度ICP的曲线下面积(AUC)分别为0.667、0.699(P<0.05)。结论NLR与ICP的发生、发展及病情程度密切相关,可用作ICP诊断和病情评估的潜在指标,指导临床诊疗,而PLR对ICP的诊断和病情程度评估均未显现价值。

Correlation between peripheral blood NLR,PLR and intrahepatic cholestasis of pregnancy

Objective To investigate the correlation between neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)and intrahepatic cholestasis of pregnancy(ICP).Methods A total of 97 patients with ICP admitted to Women and Children's Medical Center of Hainan Province from August 2019 to August 2021 were retrospectively selected as the ICP group.According to the severity of the disease,they were divided into mild ICP group(n=62)and severe ICP group(n=35).In addition,healthy pregnant women in the same period were selected as the control group(n=40).The general data of all subjects and the levels of NLR and PLR in peripheral blood were collected.Single factor,Pearson correlation coefficient and Logistic regression model were used to analyze the relationship between related indicators and ICP,and receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of NLR for ICP.Results The NLR of the ICP group was 4.86±1.65,which was significantly higher than that of the control group(3.61±1.10),and the NLR of the severe ICP group was 5.23±1.26,which was significantly higher than that of the mild ICP group(4.65±1.39),and the differences were statistically significant(P<0.05).NLR was positively correlated with serum total bile acid(sTBA)(r=0.290,P<0.05).Logistic regression analysis showed that mean platelet volume(MPV)(OR=1.241)and NLR(OR=1.902)were independent influencing factors for ICP(P<0.05).ROC curve showed that the area under the curve(AUC)of NLR in the diagnosis of mild ICP and severe ICP were 0.667 and 0.699,respectively(P<0.05).Conclusion NLR is closely related to the occurrence,development and severity of ICP,which can be used as a potential indicator for the diagnosis and assessment of ICP and guide clinical diagnosis and treatment.PLR has no value in the diagnosis and assessment of ICP.