The Effects Of Neutrophil-to-lymphocyte Ratio And Platelet-to-lymphocyte Ratio On The Efficacy Of IgA Nephropathy

Objective: To study the correlation between neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and clinical data,pathology and efficacy of IgA nephropathy(IgAN)?Methods:From January 2012 to January 2018,a total of 263 patients with IgA nephropathy first diagnosed by kidney biopsy in the first affiliated hospital of dalian medical university were collected,According to the admission criteria,72 patients were included.Basic and clinical data including age,sex,hypertension,neutrophil count,lymphocyte count,platelet count,blood creatinine,total cholesterol,triglyceride,uric acid,urea nitrogen,cystatin C,and pathological grading were collected.The neutrophil-to-lymphocyte count ratio(NLR)and platelet-to-lymphocyte count ratio(PLR)were calculated.Subjects operating curve(ROC curve),the maximum value of NLR and PLR was selected as the optimal cut-off point for grouping,and the clinical data of patients with different levels of NLR and PLR were recorded.Patients with IgAN nephropathy were divided into a 2-year remission group and a 2-year non-remission group according to whether IgAN nephropathy was in remission 2 years after treatment,the clinical data,pre-treatment NLR and PLR,and pathological grading of the two groups of patients were included in the single-factor model to analyze the factors that might relieve the disease.The factors that showed remission in single factor analysis were incorporated into the multi-factor regression model to determine the independent risk factors for remission within 2 years.The independent risk factor IgAN was plotted for 2 years.Result:The ROC curve was drawn based on the NLR value before treatment,and the area under the curve was 0.794.The optimal immediate value of NLR before treatment was determined to be 1.89,and the sensitivity and specificity were 59.3% and92.3%.According to the pre-treatment PLR value,the ROC curve was drawn,the area under the curve was 0.763,the optimal pre-treatment PLR value was determined to be129.89,and the sensitivity and specificity were 76.9% and 71.2%.There were 59 patients in IgAN remission group(35 patients with complete remission + 24 patients with partial remission)within 2 years,and 13 patients in IgAN group without remission within 2 years.Univariate analysis showed that WBC count,NLR,PLR,and M and S in the Oxford classification(mest-c)before treatment were risk factors for the remission of IgAN within 2 years.COX multivariate regression model analysis showed that the NLR level before treatment might not be an independent risk factor for the remission of IgAN within 2 years(P > 0.05).Before treatment,PLR was an independent risk factor for IgAN remission within 2 years(P < 0.05).Compared with the 2-year remission survival curve by log-rank method,the 2-year remission rate of patients in the high-plr group(>129.89)before treatment was significantly lower than that in the low-plr group(?129.89)(P < 0.05).Conclusion:1.High level of PLR before treatment may be an independent risk factor for IgAN remission within 2 years,which has certain predictive value for IgAN remission after treatment.2.High levels of NLR before treatment may not be an independent risk factor for IgAN remission within 2 years,and there is no predictive value for IgAN remission after treatment.