中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值与溃疡性结肠炎内镜活动度相关性

The correlation analysis among NLR,PLR and endoscopic disease severity in ulcerative colitis

[目的]研究中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)与溃疡性结肠炎(ulcerative colitis,UC)患者Mayo内镜下评分(Mayo endoscopic score,MES)的相关性。比较NLR、PLR、C-反应蛋白(C-reactive protein,CRP)独立及联合评价内镜活动度的效能。[方法]收集2016-01-2019-06期间于武汉大学中南医院消化内科住院治疗的UC患者205例(内镜活动期UC 150例,内镜缓解期UC 55例)和年龄、性别匹配的健康对照者205例。收集纳入对象的一般临床信息及NLR、PLR、CRP及结肠镜MES等结果。[结果]UC组患者NLR、PLR明显高于健康对照组,内镜活动期UC患者NLR、PLR高于内镜缓解期患者;NLR、PLR均与MES、CRP、WBC呈正相关;NLR、PLR区分内镜活动期UC与内镜缓解期UC的最佳临界值分别为2.05(灵敏度77.3%、特异度60%)、184.77(灵敏度35.3%、特异度90.9%);虽然NLR、PLR独立预测UC内镜活动度的预测效能不如CRP,但是NLR、PLR联合CRP后预测效能较NLR、PLR独立预测时均有提高。而且CRP+NLR、CRP+NIR+PLR预测效能高于CRP独立预测效能,CRP+NLR预测内镜活动度的效能最高。[结论]NLR、PLR均可区分内镜活动期UC与内镜缓解期UC,且与MES、CRP、WBC呈正相关,NLR预测效能优于PLR。NLR、PLR独立预测UC内镜活动效能不如CRP,CRP联合预测效能较独立预测时均有提高,NLR联合CRP预测内镜活动度的效能最高。

[Objective]To evaluate the relationship of NLR,PLR with Mayo endoscopic score(MES)in ulcerative colitis and explore the sensitivity of NLR and PLR,as well as combination of CRP to predict endoscopic disease severity based on mucosal assessment in ulcerative colitis.[Methods]The results of NLR,PLR,CRP and other inflammatory markers in 205 cases of UC patients(endoscopic active n=150,endoscopic remission n=55)and 205 of healthy controls were collected.Endoscopic severity was described with Mayo endoscopic score(MES).NLR,PLR were compared between the two groups and in different stages of UC.The ROC Curve was used to evaluate the optimal cutoff value of NLR,PLR and the area under curve(AUC).[Results]The level of NLR,PLR in UC group were higher than the healthy control group,the endoscopic active group were higher than the endoscopic remission group.Both NLR,PLR showed a positive correlation with MES,CRP and WBC.The receiver operating characteristic(ROC)analysis revealed that the optimum cut-offs of NLR and PLR were 2.05 and 184.77 for endoscopic active UC with sensitivity 77.3%,35.3%,specificity 60%,90.9%.[Conclusion]NLR and PLR can distinguish endoscopic active UC from endoscopic remission UC,in which NLR are more effective than PLR.However,the independent prediction efficiency of them are less than CRP.The prediction efficiency is improved when combining NLR,PLR with CPR,while the combination of NLR with CRP shows best efficiency.