The relationship between pulmonary artery pressure and neutrophil/lymphocyte rate, platelet/lymphocyte rate and mean platelet volumein systemic sclerosis disease

PURPOSE: Systemic sclerosis is a systemic connective tissue disease of unknown etiology, which is characterized with progressive skin thickening and is associated with vasculopathy, immune activation and fibrosis. Obliterative vasculopathy of small and medium-sized pulmonary vasculature leads to isolated PAH (pulmonary arterial hypertension) in patients with systemic sclerosis disease. In addition, PAH interstitial fibrosis and cardiac involvement may also develop secondarily in patients with systemic sclerosis. MPV, NLR (neutrophil lymphocyte rate), PLT (platelet lymphocyte rate) values have recently been reported to be indicators of systemic inflammation and to be associated with prognosis in several chronic inflammatory diseases, malignancies and cardiovascular diseases. The aim of our study is to present the usability of the practical, cheap and easily accessible NLR, PLR and MPV tests in the prognosis and monitoring of pulmonary artery pressure arising from systemic sclerosis s known to be associated with inflammation. MATERIAL AND METHOD:The study group consisted of a total of 38 patients between ages 18-65 who applied to Yüzüncü Yıl University Faculty of Medicine Physical Medicine and Rehabilitation Department, PM&R-Rheumatology Clinic and were diagnosed with systemic sclerosis according to the ACR/EULAR classification criteria, whose treatment process was on-going in PM&R-Rheumatology Clinic. The patients were divided into two groups based on their sPAB values detected in transthoracic echocardiography. 17 patients with sPAB<25 were included in Group 1 and 21 patients with sPAB≥25 were included in Group 2. Hemogram values of the patients were examined by taking blood samples. Hemogram MPV, NLR and PLR values were recorded. Thereafter, the presence of a correlation between pulmonary artery pressure and MPV (mean platelet volume), NLR (neutrophil lympochyte rate) and PLR (platelet lymphocyte rate) was analysed. RESULTS: The NLR value was found to be 3.21±2.21 in the group with sPAB≥ 25mmHg where as it was 1.75±0.65 in the group with sPAB<25 mmHg.There was a statistically significant difference (p=0.013).The PLR value was found to be 243.10±213.790 in the group with sPAB≥ 25mmHg whereas it was 128.90±57.752 in the group with sPAB< 25 mmHg, which was a statistically significant difference (p = 0.040). The intergroup MPV value was not statistically significant. There was a moderate-level positive correlation between the CRP level and sPAB (r = 0.437, p<0.01). There was no correlation between PLR and sPAB. CONCLUSION: We have concluded that;the NLR and PLR values were significantly high in the group with high sPAB in systemic sclerosis and these values could be the parameters that need to be considered in sPAB value estimation and monitoring.