外周血中性粒细胞/淋巴细胞比值及中性粒细胞群落参数在类风湿关节炎诊断中的应用价值

Diagnostic value of peripheral blood neutrophil to lymphocyte ratio and neutrophil cell population data for rheumatoid arthritis

目的探讨外周血中性粒细胞/淋巴细胞比值(NLR)及中性粒细胞群落参数在类风湿关节炎诊断中的应用价值。方法抽取2020年6月至2020年9月在郑州大学第一附属医院就诊的已确诊的类风湿关节炎患者125例作为类风湿关节炎组,另抽取同期进行体检的健康人137例作为健康对照组。检测两组全血细胞计数及C-反应蛋白(CRP)水平,记录两组血常规检测结果和中性粒细胞群落参数[侧向散射光强度(Neu-X)、荧光染色信号强度(Neu-Y)、前向散射光强度(Neu-Z)],计算两组中性粒细胞-淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR),并比较两组间上述各指标的差异。绘制受试者工作特征曲线分析这些指标对类风湿关节炎的诊断价值。结果类风湿关节炎组患者的白细胞计数、中性粒细胞绝对值、血小板计数、NLR、PLR及中性粒细胞Neu-X均高于健康对照组(P均<0.05),而淋巴细胞绝对值和中性粒细胞Neu-Z低于健康对照组(P<0.05)。NLR、Neu-X、Neu-Z对类风湿关节炎诊断的曲线下面积分别为0.678,0.592,0.614,三者联合检测的曲线下面积达0.765,三者联合检测具有更高的诊断价值。结论外周血NLR、Neu-X、Neu-Z联合检测对类风湿关节炎具有较高的临床诊断价值。

Objective To investigate the diagnostic value of peripheral blood neutrophil to lymphocyte ratio(NLR)and neutrophil cell population data for rheumatoid arthritis.Methods A total of 125 patients with rheumatoid arthritis diagnosed in the First Affiliated Hospital of Zhengzhou University from June 2020 to September 2020 were selected as the rheumatoid arthritis group,another 137 healthy people who underwent physical examination in the same period were selected as the healthy control group.The whole blood cell count and the level of C-reactive protein(CRP)were measured,the blood routine test results and neutrophil cell population data(Neu-X,Neu-Y,Neu-Z)of the two groups were recorded.The neutrophil-lymphocyte ratio(NLR)and preoperative platelet-lymphocyte ratio(PLR)of the two groups were calculated.The differences of the above indexes between the two groups were compared.The receiver operating characteristic curve was drawn to analyze the diagnostic value of these indexes for rheumatoid arthritis.Results The white blood cell count,absolute neutrophil count,platelet count,NLR,PLR and neutrophil Neu-X in rheumatoid arthritis group were higher than those in the healthy control group(all P<0.05),while the absolute lymphocyte count and Neu-Z of neutrophils in rheumatoid arthritis group were lower than those in healthy control group(P<0.05).The areas under the curve of NLR,Neu-X and Neu-Z in the diagnosis of RA were 0.678,0.592,and 0.614,respectively,and the area under the curve of the combined detection of NLR,Neu-X and Neu-Z was 0.765,the combined detection of NLR,Neu-X and Neu-Z has higher diagnostic value.Conclusions The combined detection of NLR,Neu-X and Neu-Z in peripheral blood has high clinical diagnostic value for rheumatoid arthritis.