中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值与大动脉炎疾病活动性的关联性及其应用价值

Neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)were useful markers in assessment of inflammatory response and disease actvity in patients with Takayasu Arteritis

目的评估大动脉炎患者的中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)水平及其与疾病活动的关联性及其应用价值。方法纳入空军军医大学第二附属医院风湿免疫科2013年1月至2019年12月的住院和门诊随访病例55例(大动脉炎组),对其实验室检查、影像学检查及治疗方法进行分析。选取同时期体检的健康者56例(健康对照组)。对两组间的临床资料进行比较,采用Spearman相关系数评价NLR和PLR与Kerr评分、红细胞沉降率(ESR)和C反应蛋白(CRP)的关系,采用受试者工作特征(ROC)曲线确定大动脉炎疾病活动的界值。结果大动脉炎组的NLR和PLR均显著高于健康对照组(2.58±0.15 vs.1.87±0.11,P<0.01;175±11 vs.119±4,P<0.01)。NLR与CRP(r=0.36,P<0.05)和ESR(r=0.37,P<0.05)呈正相关,与Kerr评分呈负相关(r=-0.31,P<0.05)。PLR与CRP(r=0.65,P<0.01)和ESR(r=0.76,P<0.01)呈正相关。PLR判断大动脉炎的最佳界值为163(灵敏度95%;特异度45%),ROC曲线下面积为0.706。NLR判断大动脉炎的最佳界值为1.88(灵敏度68%;特异度78%),ROC曲线下面积为0.726。结论NLR和PLR可用于判断大动脉炎患者的疾病活动性。

AIM Although neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR)have been investigated higher in many inflammatory diseases, their roles in Takayasu Arteritis(TA) was still unclear. Herein, we evaluated NLR and PLR level in TA patients and their association with disease activity. METHODS A retrospective study enrolled 55 adult patients with TA and 56 healthy individuals. Complete clinical and demographic characteristics of TA patients were obtained from their medical records. Similar data were extracted from the controls. The correlations between NLR, PLR and disease activity were analyzed. RESULTS NLR and PLR were increased in TA patients as compared with those in healthy controls(2.58 ± 0.15 vs.1.87 ± 0.11, P<0.01;175 ± 11 vs.119 ± 4, P<0.01).NLR was positively correlated with CRP(r = 0.36, P<0.05) and ESR(r = 0.37, P<0.05), and negtively correlated with Kerr score(r =-0.31, P<0.05). PLR was positively correlated with CRP(r = 0.65, P<0.01) and ESR(r =0.76, P<0.01). The AUC for PLR was 0.706(sensitivity 95%;specificity 45%), at a cut-off value of 163.The AUC for NLR was 0.726(sensitivity 68%;specificity 78%), at a cut-off value of 1.88.CONCLUSIOIN PLR and NLR could predict disease activity in TA patients.