【摘要】 目的 探讨平均血小板体积/淋巴细胞比值（MPVLR）、淋巴细胞与单核细胞的比值（LMR）与寻常型银屑病（PsV）及银屑病关节炎的相关性。方法 选取2018年4月—2021年4月我院治疗的102例银屑病患者，其中PsV85例，银屑病关节炎17例，另选取同期于我院皮肤外科及美容科的健康人群60例作为对照组。收集患者及健康对照的年龄、性别、首发年龄、病程、家族史及血液常规检测指标，计算MPVLR、LMR比值。绘制受试者工作特征曲线（ROC）并计算曲线下面积（AUC），分析MPVLR、LMR对银屑病患者的诊断价值，多因素Logistic回归分析探讨银屑病患者关节炎的相关因素。结果 与正常对照组相比，PsV组和银屑病关节炎组的白细胞计数（WBC）、单核细胞计数（MONO）、C反应蛋白（CRP）、MPVLR均显著上升，血红蛋白（Hb）、LMR均显著下降（均P<0.05）。银屑病关节炎组的血小板计数（PLT）明显高于对照组，淋巴细胞计数（LYM）明显低于对照组（均P<0.05）。与PsV组相比，银屑病关节炎组的PLT、CRP、MPVLR明显升高，LYM、Hb、LMR均明显降低（均P<0.05）。Spearman相关分析结果：MPVLR与CRP、银屑病皮损面积和严重程度指数（PASI）评分呈正相关，LMR与CRP、PASI呈负相关（r分别为0.663、0.611、-0.616、-0.678，均P<0.05）。MPVLR、LMR在预测银屑病的ROC AUC分别为0.794(95%CI:0.726～0.861)、0.748(95%CI:0.674～0.817)。在5.65的临界值下，MPVLR的敏感度为76.5%，特异度为80.3%；在4.56的临界值下，LMR预测的敏感度为74.4%，特异度为76.8%。多因素Logistic回归分析结果显示：MPVLR、CRP是银屑病患者发生关节炎的危险因素，OR及95%CI分别为1.742(1.122～2.714)及1.539(1.007～2.349)。LMR是银屑病患者发生关节炎的保护因素，OR及95%CI为0.694(0.532～0.906)。结论 PsV患者MPVLR升高、LMR降低，银屑病关节炎患者MPVLR更高、LMR更低，MPVLR、LMR对银屑病有较好的诊断效能，有望成为反映银屑病严重程度的生物标志物。更多还原

【Abstract】 Objective In order to investigate the correlation between mean platelet volume to lymphocyte ratio(MPVLR),lymphocyte to monocyte ratio(LMR) and psoriasis vulgaris(PsV) and psoriatic arthritis. Methods Totally 102 patients with psoriasis treated in our hospital from April 2018 to April 2021 were selected,including 85 cases of PsV,17 cases of psoriatic arthritis,and 60 healthy people in the skin surgery and beauty department of our hospital during the same period served as the control group. The age,gender,age of first onset,disease course,family history and blood routine test indicators of patients and healthy controls were collected,and the MPVLR and LMR ratios were calculated. The receiver operating characteristic curve(ROC) and area under the curve(AUC) were used to analyze the diagnostic value of MPVLR and LMR in patients with psoriasis,and multivariate logistic regression analysis to explore the related factors of arthritis in patients with psoriasis.Results Compared with the normal control group,the levels of white blood cell count(WBC),monocyte count(MONO),Creactive protein(CRP) and MPVLR in the PsV group and psoriatic arthritis group increased,while Hemoglobin(Hb) and LMR decreased(all P<0.05). The platelet count(PLT) of the psoriatic arthritis group was higher than that of the control group,and the lymphocyte count(LYM) was lower than that of the control group(all P<0.05). Compared with the PsV group,the PLT,CRP and MPVLR of the psoriatic arthritis group were increased,while LYM,Hb,and LMR were decreased(all P<0.05).Spearman correlation analysis results showed that MPVLR was positively correlated with CRP and PASI,and LMR was negatively correlated with CRP and PASI(r=0.663,0.611,-0.616,-0.678,all P<0.05). The AUC of MPVLR and LMR in predicting psoriasis were 0.794(95%CI:0.726-0.861) and 0.748(95%CI:0.674-0.817),respectively. Under the critical value of 5.65,the sensitivity of MPVLR was 76.5% and the specificity was 80.3%;under the critical value of 4.56,the sensitivity of LMR prediction was 74.4% and the specificity was 76.8%. Multivariate logistic regression analysis showed that MPVLR and CRP were risk factors for arthritis in patients with psoriasis,and the OR and 95%CI were 1.742(1.122-2.714) and 1.539(1.007-2.349),respectively. LMR was a protective factor for arthritis in patients with psoriasis,with an OR and 95% CI of 0.694(0.532-0.906). Conclusion The level of MPVLR in patients with PsV is increased and the level of LMR is decreased. The level of MPVLR in patients with psoriatic arthritis is higher and the level of LMR is lower. MPVLR and LMR have good diag-nostic efficiency for psoriasis and are expected to be biomarkers for reflecting the severity of psoriasis.更多还原