中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值与结缔组织病相关间质性肺病疾病活动性的关系

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in relation to disease activity in connective tissue disease-associated interstitial lung disease

目的评估中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)与结缔组织病相关间质性肺病(CTD-ILD)疾病活动性的关系。方法收集2013年1月至2019年12月在空军军医大学唐都医院风湿免疫科住院及门诊的CTD-ILD患者38(男24,女14)例,作为CTD-ILD活动组。对CTD-ILD患者进行规范治疗及严密随访6个月,除1例女性患者失访外,其余37(男24,女13)例患者病情均得到明显缓解,设为CTD-ILD缓解组。收集同期年龄、性别相匹配的正常体检者38例作为健康对照组。比较CTD-ILD活动组和健康对照组,CTD-ILD活动组和CTD-ILD缓解组的临床资料,评估NLR和PLR与CTD-ILD疾病活动性的关系。结果CTD-ILD活动组NLR和PLR均较健康对照组显著升高,差异具有统计学意义[(3.55±0.40)vs(2.03±0.12),P<0.01;(177.10±14.74)vs(131.40±7.31),P<0.01]。CTD-ILD缓解组的PLR显著下降,差异具有统计学意义[(177.10±14.47)vs(126.60±11.79),P<0.01]。NLR与红细胞沉降率(ESR)(r=0.38,P<0.05)和C反应蛋白(r=0.44,P<0.01)呈正相关,PLR与ESR呈正相关(r=0.50,P<0.01)。NLR判断CTD-ILD疾病活动性的最佳界值为2.12(敏感度71.05%,特异度74.29%),受试者工作特征(ROC)曲线下面积为0.756。PLR判断CTD-ILD疾病活动性的最佳界值为173.60(敏感度86.84%,特异度40.00%),ROC曲线下面积为0.623。结论NLR和PLR可用于判断CTD-ILD患者的疾病活动性。

Objective To evaluate the relationship between neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)and disease activity in connective tissue disease-associated interstitial lung disease(CTD-ILD).Methods Thirty-eight inpatients and outpatients with CTD-ILD in the Department of Rheumatology and Immunology,Tangdu Hospital,Air Force Medical University from January 2013 to December 2019 were enrolled as CTD-ILD active group.CTD-ILD patients were treated with standard treatment and followed up closely for 6 months.Except for one female patient who was lost to follow-up,the other 37 patients(24 males and 13 females)were all significantly relieved and were set as CTD-ILD remission group.Thirty-eight subjects in our hospital for normal physical examination in the same period were selected as healthy control group.The clinical data of CTD-ILD active group and healthy control group,and CTD-ILD active group and CTD-ILD remission group were compared to evaluate the relationship between NLR and PLR and disease activity of CTD-ILD.Results NLR and PLR significantly increased in CTD-ILD active group compared with those in healthy control group,with statistical significance(3.55±0.40 vs 2.03±0.12,P<0.01;177.10±14.74 vs 131.40±7.31,P<0.01).PLR decreased significantly in CTD-ILD remission group,with statistical significance(177.10±14.74 vs 126.60±11.79,P<0.01).NLR was positively correlated with erythrocyte sedimentation rate(ESR)(r=0.38,P<0.05)and C-reactive protein(r=0.44,P<0.01).PLR was positively correlated with ESR(r=0.50,P<0.01).The optimal cutoff value of NLR to determine the disease activity of CTD-ILD was 2.12(sensitivity 71.05%,specificity 74.29%),and the area under the ROC curve(AUC)was 0.756.The optimal cutoff value of PLR to determine the disease activity of CTD-ILD was 173.60(sensitivity 86.84%,specificity 40.00%),and the AUC was 0.623.Conclusion PLR and NLR can be used to predict disease activity in CTD-ILD patients.