中性粒细胞/淋巴细胞与血小板/淋巴细胞评估大动脉炎活动性的临床研究

Association between Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio with Disease Activity in Takayasu Arteritis Patients

目的探讨中性粒细胞/淋巴细胞(neutrophil-to-lymphocyte ratio,NLR)及血小板/淋巴细胞(platelet-to-lymphocyte ratio,PLR)与大动脉炎(Takayasu arteritis,TA)活动性的相关性。方法采用回顾性研究方法,纳入2015年1月至2018年12月在中国医学科学院阜外医院住院治疗的TA患者,根据Kerr评分将TA患者分为活动组(Kerr评分≥2分)和非活动组(Kerr评分≤1分)。对两组间的临床资料进行比较,采用Pearson相关分析评价NLR和PLR与Kerr评分、红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)的关系,采用受试者工作特征(receiver operating characteristic,ROC)曲线确定判断TA疾病活动性的界值。结果共收集TA患者166例,平均年龄(33.5±12.5)岁,女性141例(84.94%),活动组50人(30.12%)。TA活动组的NLR明显高于非活动组[2.89(1.27,19.98)vs 2.19(1.01,10.00),P<0.001],而活动组的PLR与非活动组对比无明显差异[137.08(40.01,736.66)vs118.56(48.34,399.85),P=0.145]。Pearson线性相关性分析NLR与Kerr评分(r=0.362,P<0.001),ESR(r=0.324,P<0.001)和CRP(r=0.287,P<0.001)均呈正相关。NLR判断TA疾病活动性的最佳界值为2.39(敏感度为75.0%,特异度为65.2%,ROC曲线下面积为0.740)。结论NLR有可能作为判断TA炎症活动性的指标。

Objective To explore the relation between neutrophil-to-lymphocyte ratio(NLR)or platelet-to-lymphocyte ratio(PLR)with disease activity in Takayasu arteritis(TA)patients.Methods Patients with TA in Fuwai Hospital from January 2015 to December 2018 were consecutively recruited.TA patients were further divided into active and inactive groups according to Kerr scores.Clinical data were compared between groups.Pearson correlation analysis was used to evaluate the relationship between NLR or PLR and disease activity(Kerr score or C-reactive protein or erythrocyte sedimentation rate).Receiver operating characteristic(ROC)curve was employed to judge the cut-off value of disease activity for TA patients.Results A total of 166 patients were collected,with an average age of(33.5±12.5)years old,141 females(84.94%),and 50 patients(30.12%)in the active group.NLR was significantly higher in active group than in inactive group[2.89(1.27,19.98)vs 2.19(1.01,10.00),P<0.001],while the PLR of the active group was not significantly different from the inactive group[137.08(40.01,736.66)vs 118.56(48.34,399.85),P=0.145].Pearson correlation analysis showed that NLR was positively correlated with Kerr score(r=0.362,P<0.001),ESR(r=0.324,P<0.001)and CRP(r=0.287,P<0.001).A NLR level of 2.39 was shown to be the best predictive cut-off value for TA disease activity(sensitivity 75.0%,specificity 65.2%,and area under the curve was 0.740).Conclusion NLR may be used as an indicator of TA inflammatory activity.