背景:克雅氏病(CJD)是一种致命且不可逆的神经退行性疾病。识别廉价且易于实施的CJD生物标志物,可以预测疾病严重程度和患者生存率,对于改善疾病管理很重要。这项研究的目的是评估外周中性粒细胞与淋巴细胞比率(NLR)的预测价值,高密度脂蛋白(HDL),CJD的单核细胞与HDL比率(MHR)和中性粒细胞与HDL比率(NHR)。
方法:选取2014-2021年宣武医院神经内科收治的明确或可能的CJD患者,随访至2022年4月。临床信息包括性别,年龄,巴特指数,收集生存时间和辅助检查结果,和NLR,HDL,对所有入选患者测量NHR和MHR。NLR之间的关联,HDL,NHR和MHR,和疾病严重程度(通过Barth指数评估),评估生存时间和辅助检查。
结果:共纳入88例CJD患者,全部死亡。NLR(r=-0.341,p=0.001),NHR(r=-0.346,p=0.001)和MHR(r=-0.327,p=0.002)与疾病严重程度显着相关。较高的NHR(HR=2.344,95%CI=1.277-4.303p=0.006)和较低的HDL(HR=0.567,95%CI=0.346-0.930,p=0.025)与CJD患者的生存时间较短相关。
结论:外周炎症生物标志物,尤其是NHR,与疾病严重程度和生存时间有关。这些发现为CJD的机制和治疗策略提供了新的见解。
BACKGROUND: Creutzfeldt-Jakob disease (CJD) is a fatal and irreversible neurodegenerative disease. Identification of inexpensive and easy-to-implement biomarkers of CJD which could predict disease severity and patient survival is important for improving disease management. The aim of this study was to assess the predictive value of peripheral neutrophil to lymphocyte ratio (NLR), high-density lipoprotein (HDL), monocyte to HDL ratio (MHR) and neutrophil to HDL ratio (NHR) for CJD.
METHODS: Patients with definite or probable CJD admitted to the Neurology Department of Xuanwu Hospital from 2014 to 2021 were enrolled and followed up until April 2022. Clinical information including sex, age, Barth Index, survival time and results of auxiliary examination were collected, and NLR, HDL, NHR and MHR were measured for all enrolled patients. The associations between NLR, HDL, NHR and MHR, and disease severity (evaluated by Barth Index), survival time and auxiliary examinations were evaluated.
RESULTS: A total of 88 CJD patients were enrolled and all were deceased. NLR (r = -0.341, p = 0.001), NHR (r = -0.346, p = 0.001) and MHR (r = -0.327, p = 0.002) were significantly associated with disease severity. Higher NHR (HR = 2.344, 95% CI = 1.277-4.303 p = 0.006) and lower HDL (HR = 0.567, 95% CI = 0.346-0.930, p = 0.025) were associated with shorter survival time in the CJD patients.
CONCLUSIONS: Peripheral inflammatory biomarkers, especially NHR, were associated with disease severity and survival duration. These findings provide new insights into the mechanisms and treatment strategies of CJD.