中性粒细胞/淋巴细胞比值与中重度寻常型银屑病活动性相关性研究

Study on the relationship between neutrophil/lymphocyte ratio and the activity of moderate to severe psoriasis vulgaris

目的探讨中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)评价中、重度寻常型银屑病患者疾病活动性的临床价值。方法纳入70例中、重度寻常型银屑病患者,根据银屑病皮损面积和严重程度指数(psoriasis area and severity index,PASI)评分将其分为中度组(n=36)和重度组(n=34);根据疾病活动性分期分为活动期、稳定期和消退期。分别比较各组间NLR、红细胞沉降率(erythrocyte sedimentation rate,ESR)及C反应蛋白(C-reactive protein,CRP)等指标。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)探讨NLR水平对银屑病活动性的诊断效能。结果在中度和重度组中,活动期患者与消退期患者相比均表现出较高的NLR(P<0.05),且在重度银屑病患者中,活动期患者NLR高于稳定期患者(P<0.05)。CRP在活动期、稳定期及消退期三者间均有差异(P<0.05)。ESR仅在重度组患者活动期和消退期两者间有差异(P<0.05)。ROC曲线分析显示,当NLR为2.43时诊断银屑病活动性效能最高(敏感度为74%,特异度为85%)。结论本研究结果表明NLR可以作为评价银屑病病情活动的客观参考指标。

Objective To analyze the correlation between neutrophil/lymphocyte ratio(NLR)and the activity of moderate to severe psoriasis vulgaris.Methods A total of 70 patients with moderate to severe psoriasis vulgaris were selected and divided into different groups.According to psoriasis area and severity index(PASI)score,psoriasis was divided into moderate group(n=36)and(n=34)severe group.According to the stages of disease activity,it can be divided into active period,stable period and fading period.According to different groups,NLR,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)were compared respectively.Receiver operating characteristic curve(ROC)was used to evaluate the predictive effect of NLR levels on psoriasis disease activity.Results In the moderate and severe groups,patients in active phase showed higher NLR than patients in fading phase(P<0.05),in patients with severe psoriasis,NLR of active patients is higher than that of stable patients(P<0.05).CRP was different between the active phase,stable phase and fading phase(P<0.05).ESR was only different between active phase and fading phase in severe group(P<0.05).Analysis of ROC curve shows that when NLR is 2.43,the diagnostic efficiency is the highest,the sensitivity is 74%and the specificity is 85%.Conclusion NLR can be used as one of the indexes for judging the activity of psoriasis.