| 姚倩,张威,张周傲,等.血红蛋白、白蛋白、淋巴细胞和血小板评分、红细胞体积分布宽度与重症肌无力病人发病及疾病严重程度相关性的临床研究[J].安徽医药,2026,30(3):542-547. |
| 血红蛋白、白蛋白、淋巴细胞和血小板评分、红细胞体积分布宽度与重症肌无力病人发病及疾病严重程度相关性的临床研究 |
| Clinical study on the correlation between hemoglobin, albumin, lymphocyte, and platelet score, red blood cell distribution width, and the onset and severity of myasthenia gravis |
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| DOI：10.3969/j.issn.1009-6469.2026.03.022 |
| 中文关键词: 重症肌无力 血红蛋白、白蛋白、淋巴细胞和血小板评分 红细胞体积分布宽度 疾病严重程度 危险因素 |
| 英文关键词: Myasthenia gravis Hemoglobin, albumin, lymphocyte, and platelet score Red blood cell distribution width Disease severity Risk factor |
| 基金项目:江苏省科技计划专项资金面上项目( BK20231158)；江苏省研究生实践创新计划项目( SJCX23_1393) |
| 作者 | 单位 | E-mail | | 姚倩 | 徐州医科大学附属医院神经内科,江苏徐州22,1004 | | | 张威 | 徐州医科大学附属医院神经内科,江苏徐州22,1004 | | | 张周傲 | 徐州医科大学附属医院神经内科,江苏徐州22,1004 | | | 徐铭铭 | 慈溪市第三人民医院神经内科,浙江宁波 315324 | | | 张勇 | 徐州医科大学附属医院神经内科,江苏徐州22,1004 | | | 肖成华 | 徐州医科大学附属医院神经内科,江苏徐州22,1004 | xiaochenghuaphd@foxmail.com |
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| 中文摘要: |
| 目的探讨血红蛋白、白蛋白、淋巴细胞和血小板( HALP)评分、红细胞体积分布宽度( RDW)与重症肌无力( MG)病人发病及疾病严重程度的相关性。方法回顾性选取 2018年 9月至 2023年 11月徐州医科大学附属医院收治的 172例 MG病人作为 MG组，同期该院体检健康的 179例健康成人作为健康组。收集两组临床基线资料及血液学指标，比较 MG组与健康组血液学指标的差异。根据 MG病人临床特点进行亚组分类，包括早发型和晚发型、眼肌型和全身型、乙酰胆碱受体抗体(AChR-Ab)阳性和阴性、胸腺瘤型和非胸腺瘤型，并根据美国重症肌无力基金会( MGFA)分型评估病人严重程度。比较不同亚组 MG病人之间的血液指标差异，采用 Spearman相关性分析 HALP评分、 RDW与 MG严重程度的相关性。使用 logistic回归分析探索 MG发病的危险因素，受试者操作特征曲线( ROC曲线)评估 HALP评分、 RDW及两者联合对 MG发病的预测价值。结果与健康组相比， MG组 HALP评分［40.64(28.98，54.68)分］低于健康组［59.67(48.08，70.84)分］、 RDW［13.00%(12.50%，13.58%)］高于健康［12.70%(12.30%，13.10%)］(P<0.05)。不同 MG亚组比较发现全身型 MG组 HALP评分［36.34(24.24，52.68)分］低于眼肌型 MG组［43.10(34.53，59.36)分］、 RDW［13.30%(12.65%，14.25%)］高于眼肌型 MG组［12.70%(12.40%，13.20%)］(P<0.05)。 HALP评分与 MG病人严重程度呈负相关( rs=.0.26，P<0.05)RDW与 MG病人严重程度呈正相关( rs=0.28，P<0.05)。 logistic回归分析显示， HALP评分降低、 RDW升高可能是影响 MG发病，的独立危险因素( P<0.05)。 HALP评分、 RDW和两者联合预测 MG发病的曲线下面积( AUC)及其 95%CI分别为 0.76(0.71，0.80)、 0.63(0.58，0.68)和 0.78(0.73，0.82)；两者联合预测效能高于 HALP评分和 RDW单独预测( Z=2.09、5.09，均 P<0.05)其预测 MG发病的灵敏度为 70.35%，特异度为 78.21%。结论 HALP评分、 RDW在 MG病人中存在表达异常，并与病人临床分型，及严重程度相关。 HALP评分、 RDW对 MG发病具有一定的预测价值，且两者联合具有更好的预测价值。 |
| 英文摘要: |
| Objective To investigated the correlation between the haemoglobin, albumin, lymphocyte, and platelet (HALP) score, redblood cell distribution width (RDW), and the onset and disease severity in patients with myasthenia gravis (MG).Methods A total of 172 MG patients admitted to the Affiliated Hospital of Xuzhou Medical University from September 2018 to November 2023 were retro.spectively selected as the MG group, and 179 healthy adults who underwent health checkups during the same period were selected asthe healthy control group. Clinical baseline data and relevant haematological indices were collected from both groups. MG patients werefurther categorized into subgroups based on clinical characteristics, including early-onset vs. late-onset, ocular vs. generalized, acetyl. choline receptor antibody (AChR-Ab) positive vs. negative, and thymomatous vs. non-thymomatous. Disease severity was assessed ac.cording to the Myasthenia Gravis Foundation of America (MGFA) classification. Hematological indices were compared between differ.ent MG subgroups. The correlation of the HALP score and RDW with MG severity was analyzed using Spearman's correlation. Multivar.iate logistic regression was used to identify risk factors for MG onset, and the predictive value of the HALP score, RDW, and their com. bination for MG onset was evaluated using receiver operating characteristic curve (ROC curve) analysis.Results Compared with the healthy control group, the MG group had a significantly lower HALP score [40.64 (28.98, 54.68) vs. 59.67 (48.08, 70.84)] and a higher RDW [13.00% (12.50%, 13.58%) vs. 12.70% (12.30%, 13.10%)] (P<0.05). Subgroup comparisons revealed that the generalized MG group had a lower HALP score [36.34 (24.24, 52.68) vs. 43.10 (34.53, 59.36)] and a higher RDW [13.30% (12.65%, 14.25%) vs. 12.70% (12.40%, 13.20%)] than the ocular MG group (P<0.05). The HALP score was negatively correlated with MG severity (rs=.0.26, P<0.05), while RDW was positively correlated with MG severity(rs=0.28, P<0.05). Multivariate logistic regression analysis indicatedthat a lower HALP score and a higher RDW were independent risk factors for MG onset (P<0.05). The areas under the curve (AUC) with 95%CIs for the HALP score, RDW, and their combination in predicting MG onset were 0.76 (0.71, 0.80), 0.63 (0.58, 0.68), and 0.78 (0.73, 0.82), respectively. The combined predictive efficacy was superior to that of the HALP score or RDW alone (Z=2.09, 5.09, both P<0.05), with a sensitivity of 70.35% and a specificity of 78.21%.Conclusions The HALP score and RDW are abnormally ex.pressed in MG patients and correlate with clinical subtypes and disease severity. Both indices possess predictive value for MG onset,and their combination offers enhanced predictive value. |
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