medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-290medsovet-8481Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYПрогностическая ценность гематологических индексов при системных воспалительных заболеваниях соединительной тканиThe prognostic value of hematological indices in systemic inflammatory diseases of connective tissuehttps://orcid.org/0000-0003-4087-3351МанзюкА. В.ManzyukA. V.

Манзюк Алексей Васильевич, ординатор, кафедра общей врачебной практики

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Aleksey V. Manzyuk, Resident, Department of General Medical Practice

8, Bldg. 2, Trubetskaya St., Moscow, 119991

aleksej-manzyuk@yandex.ruhttps://orcid.org/0000-0002-3748-8180МорозоваТ. Е.MorozovaT. E.

Морозова Татьяна Евгеньевна, д.м.н., профессор, заведующая кафедрой общей врачебной практики

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Tatiana E. Morozova, Dr. Sci. (Med.), Professor, Head of the Department of General Medical Practice

8, Bldg. 2, Trubetskaya St., Moscow, 119991

morozova_t_e@staff.sechenov.ruhttps://orcid.org/0000-0002-3324-5472ГерцогА. А.GertsogA. A.

Герцог Анна Алексеевна, ассистент, кафедра общей врачебной практики

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Anna A. Gertsog, Assistant, Department of General Medical Practice

8, Bldg. 2, Trubetskaya St., Moscow, 119991

gertsog_a_a@staff.sechenov.ruhttps://orcid.org/0000-0002-3136-2755ЛитвиноваМ. А.LitvinovaM. A.

Литвинова Мария Александровна, ассистент, кафедра внутренних, профессиональных болезней и ревматологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Mariia A. Litvinova, Assistant, Department of Internal Diseases, Occupational Diseases and Rheumatology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

litvinova_m_a@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202415082024012136–142Copyright © Манзюк А.В., Морозова Т.Е., Герцог А.А., Литвинова М.А., 20242024Манзюк А.В., Морозова Т.Е., Герцог А.А., Литвинова М.А.Manzyuk A.V., Morozova T.E., Gertsog A.A., Litvinova M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8481Введение

Введение. Отсутствие доступных и эффективных лабораторных маркеров делает прогнозирование обострений и прогрессирования при системных воспалительных заболеваниях соединительной ткани трудноразрешимой задачей для врачей-ревматологов и специалистов первичного звена, наблюдающих за пациентами. Гематологические индексы, рассчитываемые по общему анализу крови, продемонстрировали эффективность в прогнозировании течения ряда заболеваний.

Цель

Цель. Определить прогностическую ценность гематологических индексов общего анализа крови (RDW, MPV, PLR, NLR, LMR, PMR, PNR, SII) в прогнозировании обострений и прогрессирования системных воспалительных заболеваний соединительной ткани.

Материалы и методы

Материалы и методы. Для ретроспективного наблюдательного исследования по типу случай-контроль отбирались пациенты с системной красной волчанкой (СКВ) и АНЦА-ассоциированными васкулитами (микроскопический полиангиит, гранулематоз с полиангиитом, эозинофильный гранулематоз с полиангиитом). Пациенты с возникшим в течение 3–12 мес. обострением или прогрессированием заболевания определялись в основную группу, пациенты со стабильным заболеванием – в контрольную группу.

Результаты

Результаты. Было отобрано 60 пациентов, из которых у 25 в течение ближайших 3–12 мес. наблюдалось обострение или прогрессирование, 35 имели стабильное течение заболевания. Исходные клинико-демографические характеристики пациентов не имели значимых различий, в том числе между подгруппами с АНЦА-ассоциированными васкулитами (n = 35) и СКВ (n = 25). Пациенты в основной группе имели более высокую исходную ширину распределения эритроцитов (p < 0,001). Между группами наблюдались статистически значимые отличия в исходном уровне тромбоцитарно-лимфоцитарного, нейтрофильно-лимфоцитарного, тромбоцитарно- ейтрофильного отношений и индекса системного воспаления, но в подгруппах СКВ и АНЦА-ассоциированных васкулитов отличия были разнонаправленными.

Заключение

Заключение. Ширина распределения эритроцитов демонстрировала более высокую прогностическую ценность в отношении обострений и прогрессирования АНЦА-ассоциированных васкулитов и СКВ по сравнению с СОЭ и С-РБ и представляется наиболее универсальной среди изучаемых маркеров прогноза системных воспалительных заболеваний соединительной ткани.

Introduction

Introduction. The lack of available and effective laboratory markers makes predicting exacerbations and progression in systemic inflammatory diseases of connective tissue an intractable task for rheumatologists and primary care specialists who monitor patients. Hematological indices calculated from a complete blood count have demonstrated effectiveness in predicting the course of several diseases.

Aim

Aim. To determine the prognostic value of hematological indices of complete blood count (RDW, MPV, PLR, NLR, LMR, PMR,

PNR, SII) in predicting exacerbations and progression of systemic inflammatory diseases of connective tissue

Materials and methods

Materials and methods. For a retrospective observational case-control study, patients with systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (microscopic polyangiitis, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis) were selected. Patients with an exacerbation or progression of the disease that occurred within 3–12 months were assigned to the main group, patients with stable disease were assigned to the control group.

Results

Results. 60 patients were selected, of which 25 had an exacerbation or progression over the next 3–12 months, 35 had a stable course of the disease. The initial clinical and demographic characteristics of patients had no significant differences, including between the subgroups with ANCA-associated vasculitis (n = 35) and systemic lupus erythematosus (n = 25). Patients in the main group had a higher initial erythrocyte distribution width (p < 0.001). Statistically significant differences were observed between the groups in the baseline level of platelet-lymphocytic, neutrophil-lymphocytic, platelet-neutrophil ratios and the index of systemic inflammation, but in the subgroups of SLE and ANCA-associated vasculitis, the differences were divergent.

Conclusion

Conclusion. The red blood cell distribution width demonstrated a higher prognostic value in relation to exacerbations and progression of ANCA-associated vasculitis and SLE compared with ESR and C-reactive protein and appears to be the most universal among the studied markers of prognosis of systemic inflammatory diseases of connective tissue.

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The authors declare that there are no conflicts of interest present.