初诊溃疡性结肠炎患者的NLR、PLT变化及临床意义

Changes and clinical significance of NLR and PLT in newly diagnosed patients with ulcerative colitis

目的探讨初诊溃疡性结肠炎(UC)患者的中性粒细胞与淋巴细胞比值(NLR)、血小板计数(PLT)变化及临床意义。方法选取2012年1月至2019年1月在徐州医科大学附属医院住院的初诊UC患者130例(UC组),选择该院同期健康志愿者142例为对照组,比较两组对象的NLR、PLT。根据Truelove和Witts标准将UC组患者进一步分为轻度组50例、中度组33例、重度组47例,比较3组患者NLR、PLT水平。使用ROC曲线分析NLR、PLT及NLR联合PLT预测UC的活动性及严重程度。结果UC组NLR及PLT明显高于对照组(P<0.05)。轻度组、中度组、重度组UC患者NLR均高于对照组,中度组、重度组UC患者PLT高于对照组,重度组UC患者PLT高于轻度组及中度组,差异均有统计学意义(P<0.05)。采用Spearman相关性分析结果显示,NLR、PLT与UC严重程度呈正相关(r=0.48、0.39,P<0.05)。受试者工作特征(ROC)曲线显示,NLR联合PLT判断UC病情活动效果较好,曲线下面积(AUC)为0.81(0.76~0.87);NLR判断UC病情活动效果优于PLT,NLR、PLT的AUC分别为0.78(0.72~0.84)、0.69(0.62~0.75)。结论初诊UC患者的NLR及PLT明显升高,且与初诊UC严重程度呈正相关,NLR及PLT水平可用于评估UC的活动性及严重程度,且二者联合评估初诊UC患者疾病活动程度更佳。

Objective To investigate the changes and clinical significance of neutrophil to lymphocyte ratio(NLR)and platelet counts(PLT)in newly diagnosed patients with ulcerative colitis(UC).Methods A total of 130 newly diagnosed UC patients hospitalized in the Affiliated Hospital of Xuzhou Medical University from January 2012 to January 2019 were selected as the UC group,and 142 healthy volunteers were selected as the control group during the same period.The NLR and PLT were compared between the two groups.The patients in the UC group were further divided into the mild group(50 cases),moderate group(33 cases)and severe group(47 cases)according to the Truelove and Witts criteria.The levels of NLR and PLT were compared among 3 groups.The ROC curve was used to analyze the NLR and PLT,and the combination of NLR and PLT to predict the activity and severity of UC.Results The levels of NLR and PLT in the UC group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The NLR level of the UC patients in the mild group,moderate group and severe group was higher than that in the control group,the PLT level of the UC patients in the moderate and severe groups were higher than those in the control group,the PLT level of the UC patients in severe group was higher than that in the mild group and moderate group,and the differences were statistically significant(P<0.05).The Spearman correlation analysis results showed that the NLR and PLT levels were correlated with the UC severity(r=0.48,P<0.05).The ROC curve showed that NLR combined with PLT had a good effect in judging the UC disease activity,and the area under the curve(AUC)was 0.81(0.76-0.87).The effect of NLR for judging the UC diseaseactivity was better than PLT,AUC of NLR and PLT were 0.78(0.72-0.84)and 0.69(0.62-0.75)respectively.Conclusion The NLR and PLT levels of newly diagnosed UC patients are increased and positively correlatedwith the severity of newly diagnosed UC,which can be used to assess the activity and severity of UC.Their combination is better in evaluating the disease activity of newly diagnosed UC patients.