■新的标识,易于测量的生物标志物可能有助于临床医生诊断和治疗系统性硬化症(SSc).尽管在SSc的评估中常规评估全血计数,特定细胞源性炎症指标的诊断效用,即,中性粒细胞与淋巴细胞比率(NLR),血小板与淋巴细胞比率(PLR),和单核细胞与淋巴细胞比率(MLR),在该患者组中尚未得到严格评估。
■我们对调查NLR的研究进行了系统评价和荟萃分析,PLR,还有MLR,SSc患者和健康对照者以及有和没有相关并发症的SSc患者。PubMed,Scopus,和WebofScience从开始到2024年2月23日进行了搜索。使用经过验证的工具评估偏倚和证据确定性的风险。
■在10项符合条件的研究中,与对照组相比,SSc患者的NLR显著较高(标准平均差,SMD=0.68,95%CI0.46至0.91,p<0.001;I2=74.5%,p<0.001),和PLR值(SMD=0.52,95%CI0.21至0.83,p=0.001;I2=77.0%,p=0.005),和更高的MLR值的趋势(SMD=0.60,95%CI-0.04至1.23,p=0.066;I2=94.1%,p<0.001)。与无并发症的SSc患者相比,在患有间质性肺病的SSc中,NLR显著更高(ILD,SMD=0.31,95%CI0.15至0.46,p<0.001;I2=43.9%,p=0.11),肺动脉高压(PAH,SMD=1.59,95%CI0.04至3.1,p=0.045;I2=87.6%,p<0.001),和数字溃疡(DU,SMD=0.43,95%CI0.13至0.74,p=0.006;I2=0.0%,p=0.49)。SSc合并ILD患者的PLR显着升高(SMD=0.42,95%CI0.25至0.59,p<0.001;I2=24.8%,p=0.26)。SSc合并PAH患者的MLR显着升高(SMD=0.63,95%CI0.17至1.08,p=0.007;I2=66.0%,p=0.086),SSc合并ILD患者有较高的MLR趋势(SMD=0.60,95%CI-0.04至1.23,p=0.066;I2=94.1%,p<0.001)。
■在适当设计的前瞻性研究的结果之前,这项系统评价和荟萃分析的结果表明,血细胞衍生的炎症指标,特别是NLR和PLR,可能对SSc和特定并发症的诊断有用。
■https://www.crd.约克。AC.英国/PROSPERO/,标识符CRD42024520040。
UNASSIGNED: The identification of new, easily measurable biomarkers might assist clinicians in diagnosing and managing systemic sclerosis (SSc). Although the full blood count is routinely assessed in the evaluation of SSc, the diagnostic utility of specific cell-derived inflammatory indices, i.e., neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), has not been critically appraised in this patient group.
UNASSIGNED: We conducted a systematic
review and meta-analysis of studies investigating the NLR, PLR, and MLR, in SSc patients and healthy controls and in SSc patients with and without relevant complications. PubMed, Scopus, and Web of Science were searched from inception to 23 February 2024. Risk of bias and certainty of evidence were assessed using validated tools.
UNASSIGNED: In 10 eligible studies, compared to controls, patients with SSc had significantly higher NLR (standard mean difference, SMD=0.68, 95% CI 0.46 to 0.91, p<0.001; I2 = 74.5%, p<0.001), and PLR values (SMD=0.52, 95% CI 0.21 to 0.83, p=0.001; I2 = 77.0%, p=0.005), and a trend towards higher MLR values (SMD=0.60, 95% CI -0.04 to 1.23, p=0.066; I2 = 94.1%, p<0.001). When compared to SSc patients without complications, the NLR was significantly higher in SSc with interstitial lung disease (ILD, SMD=0.31, 95% CI 0.15 to 0.46, p<0.001; I2 = 43.9%, p=0.11), pulmonary arterial hypertension (PAH, SMD=1.59, 95% CI 0.04 to 3.1, p=0.045; I2 = 87.6%, p<0.001), and digital ulcers (DU, SMD=0.43, 95% CI 0.13 to 0.74, p=0.006; I2 = 0.0%, p=0.49). The PLR was significantly higher in SSc patients with ILD (SMD=0.42, 95% CI 0.25 to 0.59, p<0.001; I2 = 24.8%, p=0.26). The MLR was significantly higher in SSc patients with PAH (SMD=0.63, 95% CI 0.17 to 1.08, p=0.007; I2 = 66.0%, p=0.086), and there was a trend towards a higher MLR in SSc patients with ILD (SMD=0.60, 95% CI -0.04 to 1.23, p=0.066; I2 = 94.1%, p<0.001).
UNASSIGNED: Pending the results of appropriately designed prospective studies, the results of this systematic
review and meta-analysis suggest that blood cell-derived indices of inflammation, particularly the NLR and PLR, may be useful in the diagnosis of SSc and specific complications.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024520040.