Influencing factors of no-response to treatment in patients with primary immune thrombocytopenia
Objective To investigate the risk factors of no-response to treatment in patients with primary immune thrombocytopenia(ITP).Methods Clinical data of 102 ITP patients treated in Affiliated Jinhua Hospital of Zhejiang University School of Medicine from January 2020 to December 2022 were retrospectively analyzed,among whom 60 cases responded to treatment(response group)and 42 cases did not respond to treatment(non-response group).The clinical features and laboratory test results were compared between two groups.Binary multivariate logistic regression analysis was used to identify risk factors of non-responsiveness to treatment in ITP patients,and the performance of identified risk factors for predicting treatment response was analyzed with ROC curve.Results Compared with the response group,patients in the non-response group had younger ages;had lower lymphocyte count(L),higher platelet(PLT),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and platelet-to-neutrophil ratio(PNR)values;longer hospital stay,longer ITP disease courses,and higher rates of Helicobacter pylori(Hp)and hepatitis B virus(HBV)infections(all P＜0.05).Binary multivariate logistic regression analysis showed that younger age,longer hospital stay,HBV infection,and high PLR were independent risk factors for non-response to treatment in ITP patients.ROC curve analysis showed that the AUC of L for predicting non-response to ITP treatment was 0.640(95％CI:0.531-0.749,P＜0.05),with a sensitivity of 0.50 and specificity of 0.73(cut-off value of 0.975 x 109/L);the AUC of NLR was 0.626(95％CI:0.518-0.734,P＜0.05),with a sensitivity of 0.95 and specificity of 0.35(cut-off value of 2.53％);the AUC of PLR was 0.806(95％CI:0.719-0.892,P＜0.01),with a sensitivity of 0.79 and specificity of 0.75(cut-off value of 17.81％);the AUC of PNR was 0.753(95％CI:0.657-0.849,P＜0.01),with a sensitivity of 0.76 and specificity of 0.70(cut-off value of 4.17％).Conclusion Young age,longer hospital stay,HBV infection,and high PLR are risk factors for treatment non-response in ITP patients,and L,NLR,PLR,and PNR are closely related to the prognosis of ITP.
Primary immune thrombocytopeniaPrognosisLymphocyteNeutrophilsHepatitis B virus
万方数据
维普
