The Levels Of PDW,MPV,PLT In Peripheral Blood Of Patients With Lupus Nephritis And Their Clinical Significance

Introduction: By detecting the levels of platelet distribution width(PDW),mean platelet volume(MPV),and platelet count(PLT)in peripheral blood of patients with lupus nephritis(LN),the changes of various indicators and their correlation with clinical indicators were analyzed to explore their clinical significance in patients with LN.Methods: 93 patients of systemic lupus nephritis newly diagnosed in the department of Nephrology,Rheumatology and Dermatology,affiliated hospital of north sichuan medical college from July 2017 to December 2018 were collected as the LN group,and 45 cases of healthy subjects in the physical examination center were the healthy control group.The LN group were divided into the LN active group(SLEDAI-2K>9 points,63 patients)and the LN stable group(SLEDAI-2K?9 points,30 patients)according to the activity index of systemic lupus erythematosus(SLEDAI-2K-2k).The levels of PLT,MPV,PDW in peripheral blood of LN group and healthy control group were detected by blood cell analyzer,and analyze the correlation between PLT,MPV,PDW and other variables.The subject operating characteristic(ROC)curves was used to evaluate the each indicators for LN disease activity.SPSS23.0 software was used for statistical analysis of all data,and P<0.05 was considered statistically significant.Results: 1.The level of PLT and MPV in LN group were lower than those in the healthy control group(P<0.01,P<0.05),and the level of PDW were higher than those in the healthy control group(P<0.01),with statistically significant differences.2.The level of PLT(142.46±51.70)in the LN active group was lower than that in the LN stable group(181.73±82.47)and the healthy control group,and the difference was statistically significant(P<0.05,P<0.01),whlie there was no statistically significant difference in the level of PLT between the LN stable group and the healthy control group(P>0.05).The level of PDW in the LN activity group(15.82±2.41)was higher than that in the LN stability group(14.16±2.04)and the healthy control group,and the difference was statistically significant(P<0.01),whlie there was no statistically significant difference in the level of PDW between the LN stability group and the healthy control group(P>0.05).However,there was no significant difference in the level of MPV between the LN active group and the LN stable group(P>0.05).3.The level of PDW was positively correlated with SLEDAI-2K,the level of ESR and anti-dsDNA antibody(P<0.01,P<0.05,P<0.05),and negatively correlated with complement C3,C4 and PLT(P<0.05,P<0.01,P<0.01),but not with CRP and 24-hour urinary protein(P>0.05).While the level of PLT was negatively correlated with SLEDAI-2K,the level of ESR,anti-dsDNA antibody and PDW(P<0.01,P<0.05,P<0.05,P<0.01),and positively correlated with complement C3 and C4(P<0.05),but not with CRP and 24-hour urinary protein(P>0.05).The level of MPV was not significantly associated with SLEDAI-2K,ESR,anti-dsdna antibody,complement C3,C4,CRP,24-hour urinary protein,PLT,PDW(P>0.05).4.ROC curve analysis showed that the area under the curve of PLT to recognize LN disease activity was 0.627(P=0.048,95% confidence interval: 0.496-0.759)<0.7,indicating its poor ability to recognize LN disease activity.The area under the curve of PDW to recognize LN disease activity was 0.712(P=0.001,95% confidence interval: 0.599-0.824)>0.7,indicating its ability to evaluate LN disease activity moderately.The optimal cut-off value for PDW to recognize LN disease activity was 15.05%,and the Yoden index was 0.481,with sensitivity and specificity were 71.4% and 76.7% respectively.Conclusion: There is no correlation between MPV and LN disease activity.PLT and PDW may reflect LN disease activity,and PDW may be better than PLT.