The Study Of Hematological Biomarker Characteristics In Patients With Psoriasis And Their Clinical Values On The Diagnosis And Treatment

Objective:Psoriasis is a chronic inflammatory skin disease. The pathological change is epidermalkeratinocyte proliferation and hyperkeratosis. Clinically it manifested as exfoliative dermatitis. It is aheredofamilial disease. There are four types: psoriasis vulgaris, pustular, erythrodermic and joint type.There are more than90%of psoriasis belongs to the type of psoriasis vulgaris. Different types ofpsoriasis should be treated with different methods. Through the investigation of the routine bloodindicators, blood biochemical parameters and immune indicators of psoriasis patients thecharacteristics the indicators of the different types of psoriasis were summarized. It helps us tounderstand the pathogenesis of different psoriasis, diagnose different psoriasis rapidly and giveeffective treatments to the patients.Methods:292patients with psoriasis taken treatments in the hospital from Nov.2011to Dec.2012weredivided into three groups according to its clinical types: psoriasis vulgaris (225cases), psoriasis witharthritis (23cases) and erythrodermic psoriasis (44cases). And healthy people in the medicalexamination center were taken as the control group (57cases). Background information on the sexratio and age of the patients in each group had no significant difference (p>0.05). Patients took thefollowing tests:(1) Blood tests: white blood cell count (WBC), red blood cell count (RBC), thepercentage of neutrophils (NEUT%) and neutrophils absolute value (NEUT), the percentage oflymphocytes (LYMPH%), lymphocyte (LYMPH), the percentage of monocytes (MONO%),monocyte (MONO), the percentage of eosinophils (EO%), eosinophil (EO), red blood cell count(RBC), hemoglobin concentration (Hgb), hematocrit (HCT), mean corpuscular volume (MCV),mean corpuscular hemoglobin content (MCH), red blood cell volume distribution width-thecoefficient of variation (RDW-CV), platelet (PLT) mean platelet volume (MPV), platelet volumedistribution width (PDW);(2) Blood biochemical tests: serum protein: total protein (TP), albumin (ALB); blood uric acid (UA); lipids: triglycerides (TG) total cholesterol (TCH), high-densitylipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), lipoprotein-a (L (a)),apolipoprotein A1(ApoA1), apolipoprotein B (ApoB);(3) Blood immunology indexes: erythrocytesedimentation rate (ESR); immunoglobulin: IgG, IgA, IgM; inflammatory proteins: C-reactiveprotein (CRP); serum calcium (CA);(4) Molecular biology examination: soluble interleukin-2receptor (sIL-2R), interleukin-2(IL-2), interleukin-4(IL-4), white interleukin-10(IL-10) andinterleukin-12(IL-12).Use one-way ANOVA to analyze the data of test items of the patients in each group andestablish logistic regression model. Use partial forward maximum likelihood estimation method todo Logistic analysis. By the comparison of the advantages of each variable ratio (OR), thushematology detection indicators were screened that has diagnostic value on psoriasis and its typing.Results:The PASI score of erythrodermic psoriasis was significantly higher than that of psoriasisvulgaris and arthritis-type psoriasis. The blood NEUT%, PLT, CRP, ESR, PDW, TP, ALB, ApoA1,CA, sIL-2R, IL-2, IL-4, IL-10and IL-12in each sub group of psoriatic patients had significantdifference compare to that with the healthy control group (p<0.05respectively). There was obviouslydifference on the blood WBC, NEUT%, NEUT, LYMPH%, MONO, RBC, HCT, PLT, MPV, PDW,TP, ALB, TCH, ApoA1, MONO%, Hgb, UA, LDL, CRP between the patient with psoriasis vulgarisand erythrodermic psoriasis (p<0.05respectively). Our data also showed that the RBC, HCT, MPV,PDW, ALB, IgG, CRP, ESR, MONO%, Hgb, LDL of the patients with psoriasis vulgaris hadsignificant difference with that of the patients with arthritis-type psoriasis.The control and psoriasis groups were taken as the dependent variables; and all the indicators asthe independent variables, the results of binary logistic regression analysis indicated that MCH,RDW-CV, PLT, MPV, PDW, TP, CRP, HDL, LDL, CA, IgA, ApoA1, ApoB, sIL-2R, IL-2, IL-4,IL-10, IL-12were significantly correlation with of the psoriasis (p<0.05). It suggested thoseindicators were related to the onset of psoriasis. Take the arthritis-type psoriasis as the dependent variable, the logistic regression analysis withthe psoriasis vulgaris and the erythrodermic psoriasis as the independent variables indicated that theblood NEUT%, LYMPH%, MONO%, MONO, RDW-CV, PDW, CRP were significantly related tothe pathogenesis of psoriasis vulgaris and MONO%, MONO, RDW-CV, PLT, PDW, IgM, CRP toerythrodermic psoriasis.Conclusion:This study found that there are a variety of laboratory examination indexes of anomalies withpsoriasis patients, strengthen at inflammation, increased platelet, hypoalbuminemia, anemia tendency,immunoglobulin, an abnormal cytokine, tended to hyperlipidemia, high uric acid hematic disease andserum calcium decreased are as the main characteristics. We can screen out the laboratoryexamination indexes closely related to psoriasis by Logistic regression model for clinical diagnosisand treatment and condition assessment. Our research also exists insufficiency, type erythrodermicand arthritis patient cases is less, this study result in the future it is necessary to verify in the largerpopulation study.