背景:科学文献中的最新工作报道了C反应蛋白与白蛋白之比(CAR)的作用,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)可作为风湿性疾病疾病活动的生物标志物。
目的:为了研究CAR的作用,PLR和NLR可作为非系统性JIA(nsJIA)儿童疾病活动的潜在标志物,并与随访期间持续性疾病活动的风险相关。
方法:我们的前瞻性,横断面研究包括130例nsJIA患者(根据Wallace标准,74例活动性疾病和56例非活动性疾病)和62例健康对照.人口统计,在基线(T0)和3(T1)收集临床和实验室数据,6(T2),随访12(T3)和18个月(T4)。通过青少年关节炎疾病活动评分(JADAS-27)评估疾病活动。
结果:在基线时,患者的CRP和CAR高于对照组(p=0.046),而NLR和PLR没有发现差异。然而,CAR之间没有正相关,NLR,JIA患者的PLR和JADAS-27。为了更好地研究CAR的作用,NLR和PLR作为疾病活动的标志,我们使用了广义估计方程(GEE)模型,适用于所有有或没有活动性疾病的患者。根据这一分析,CAR和NLR基线水平预测6个月随访时疾病活动的风险较高(p<0.001)。
结论:CAR和NLR可提示JIA患者持续的疾病活动。它们的预测价值可以通过它们的组合使用和在随访期间观察它们的趋势来增加,因为随着时间的推移增加的CAR值可以在短时间内预测疾病爆发。
BACKGROUND: Recent works in the scientific literature reported the role of C reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as biomarkers of disease activity in rheumatic diseases.
OBJECTIVE: To investigate the role of CAR, PLR and NLR as potential markers of disease activity in children with non-systemic JIA (nsJIA) and their correlation with the risk of persistent disease activity of flare during follow up.
METHODS: Our prospective, cross-sectional study involved 130 nsJIA patients (74 with active disease and 56 with inactive disease according to Wallace criteria) and 62 healthy controls. Demographic, clinical and laboratory data were collected at baseline (T0) and at 3 (T1), 6 (T2), 12 (T3) and 18 months (T4) during follow up. Disease activity was evaluated through Juvenile Arthritis Disease Activity Score (JADAS-27).
RESULTS: At baseline, CRP and CAR were higher in patients than in controls (p = 0.046), while no differences were found for NLR and PLR. However, there was no positive correlation between CAR, NLR, PLR and JADAS-27 in JIA patients. To better investigate the role of CAR, NLR and PLR as markers of disease activity, we used a generalized estimating equation (GEE) model, applied to all patients either with or without active disease. According to this analysis, CAR and NLR baseline levels were predictive of higher risk of disease activity at 6 months follow up (p < 0.001).
CONCLUSIONS: CAR and NLR could indicate persistent disease activity in patients with JIA. Their predictive value could be increased by their combined use and by the observation of their trend during follow up, since increasing CAR values over time could predict a disease flare in the brief time.