中性粒细胞/淋巴细胞比值和血小板计数/淋巴细胞比值在评估成人斯蒂尔病炎症反应中的价值

Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio of Peripheral Blood in Patients with Adult Onset Still＇s Disease Were Useful Markers in Assessment of Inflammatory Response

目的 评估中性粒细胞/淋巴细胞比值（NLR）和血小板计数/淋巴细胞比值（PLR）作为炎症指标在成人斯蒂尔病（AOSD）患者疾病活动中的价值.方法 回顾性分析2013年1月—2016年12月在苏州大学附属第一医院入院确诊的AOSD患者70例,纳入同期健康对照者66名.提取并记录纳入人群的基线资料及实验室指标,并分析NLR和PLR与患者临床指标间的相关性.结果 与健康对照组相比,AOSD患者NLR和PLR显著增高,差异有统计学意义（NLR：5.48（5.15）vs 1.65（0.79）,w=2,484.00,P〈0.01;PLR：170.77（143.95）vs 106.45（45.27）,w=3,422.00,P〈0.01）.NLR与AOSD各项临床指标的相关性分析：AOSD患者外周血中的NLR水平与红细胞沉降率（ESR）（r=0.375,P〈0.01）、C反应蛋白（CRP）（r=0.496,P〈0.01）、碱性磷酸酶（ALP）（r=0.253,P〈0.05）、血清铁蛋白（SF）（r=0.343,P〈0.01）正相关,与谷丙转氨酶（ALT）、谷草转氨酶（AST）、乳酸脱氢酶（LDH）相关性分析差异无统计学意义（P〉0.05）;PLR水平与ESR（r=0.537,P〈0.01）、CRP（r=0.415,P〈0.01）水平正相关,与SF、ALT、AST、LDH、ALP相关性分析差异无统计学意义（P〉0.05）.结论 NLR、PLR与其他血清炎症指标一样可以作为AOSD患者疾病活动的炎症反应生物标志物.

Objective To evaluate neutrophil-to-lymphocyte ratio （NLR） and platelet-to-lymphocyte （PLR） as a inflammatory marker in adult onset still＇s disease （AOSD）. Methods The medical records of 70 AOSD patients who were hospitalized in the First Affiliated Hospital of Soochow University from January 2013 to December 2016 and age, sex-matched 66 healthy individuals were retrospectively reviewed. NLR, PLR between AOSD patients and healthy controls were compared, and correlations between these indexes and clinical characteristics were analyzed. Results The NLR and PLR were found to be significantly higher in AOSD patients when compared to the healthy control （NLR： 5.48 （5.15） vs 1.65 （0.79）, w=2,484.00, P〈0.01; PLR： 170.77 （143.95） vs 106.45 （45.270）, w=3,422.00, P〈0.01）. NLR was positively correlated with erythrocyte sedimentation rate （r=0.375, P〈0.05）, C-reaction protein （r=0.496, P〈0.01）, alkaline phosphatase （r=0.253, P〈0.01） and serum ferritin （r=0.343, P〈0.01）, and not ALT, AST or LDH （P〉0.05）. PLR was positively correlated with ESR （r=0.537, P〈0.01） and CRP （r=0.415, P〈0.01）, and not SF, ALT, AST, LDH or ALP. Conclusion NLR, PLR, together with other serum inflammatory markers prove as significant clinical tools which could be used as biomarkers for inflammatory response of disease activity in AOSD patients.