中性粒细胞/淋巴细胞比值、单核细胞/淋巴细胞比值在克罗恩病中的诊断价值及与疾病活动性的关系

The diagnostic value of neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio in Crohn’s disease and their relationship with disease activity

目的 探索血液检测指标WBC、N、L、M、NLR、MLR、CRP在克罗恩病中的诊断价值及与疾病活动性的关系。方法 收集金华市中心医院2019年1月-2021年6月诊断为克罗恩病的患者80例,根据Best克罗恩病活动指数计算法(CDAI)分为活动组与缓解组,另选取同期体检者80例作为对照组,检测各组WBC、N、L、M、CRP,并计算NLR、MLR,比较各组检测指标的差异。结果 CD组患者WBC、N、M、CRP、NLR、MLR水平均高于对照组,而L检测水平对照组高于CD组(均P<0.05);CD活动组患者WBC、N、M、CRP、NLR、MLR水平均高于缓解组(均P<0.05);而L的检测水平在2组之间无明显差异(P>0.05);ROC曲线分析显示,MLR、NLR在诊断CD中更具价值,约登指数分别为0.775、0.760,AUC分别为0.93、0.91,均P<0.05,当MLR的截断值为0.21时,敏感度和特异度分别为86.25%、91.25%,当NLR截断值为2.62时,敏感度和特异度分别为78.75%、97.50%;N、NLR在对CD活动性的诊断中具有较高的价值,约登指数分别为0.725、0.625,AUC分别为0.93、0.87,均P<0.05,当N的截断值为5.29×10^(9)/L时,敏感度和特异度分别为90.00%、82.50%,当NLR截断值为3.62时,敏感度和特异度分别为85.00%、77.50%。结论 检测NLR、MLR有助于判断CD的活动分期和治疗效果,为治疗提供依据,或可为临床诊断CD提供一定的依据。

Objective This paper aims to explore the diagnostic value of blood test indicators WBC, N, L, M, NLR, MLR, CRP in Crohn’s disease and their relationship with disease activity. Methods A total of 80 patients diagnosed with Crohn’s disease in Jinhua Central Hospital from January 2019 to June 2021 were collected. According to the Best Crohn’s Disease Activity Index(CDAI), they were divided into active group and remission group;in addition, 80 individuals who received physical examinations during the same period were selected as the control group. WBC, N, L, M, CRP were detected in each group, NLR and MLR calculated, and the differences of both groups were compared. Results The levels of WBC, N, M, CRP, NLR, and MLR in the CD group were higher than those in the control group, while the L level in the control group was higher than that in the CD group(P<0.05). The levels of WBC, N, M, CRP, NLR, and MLR in the CD activity group were higher than those in the remission group(P<0.05);while there was no significant difference in the detection level of L between the two groups(P>0.05). ROC curve analysis shows that MLR and NLR are more valuable in diagnosing CD. Youden’s index is 0.775 and 0.760 respectively, and AUC is 0.93 and 0.91(P<0.05). When the cut-off value of MLR is 0.21, the sensitivity and specificity is 86.25% and 91.25%, respectively. When the cut-off value of NLR is 2.62, the sensitivity and specificity are 78.75% and 97.50%, respectively. N and NLR are of high value in the diagnosis of CD activity. The Youden index is 0.725 and 0.625, respectively, and the AUC is 0.93 and 0.87 respectively(P<0.05). When the cut-off value of N is 5.29×10^(9)/L, the sensitivity and specificity are 90.00% and 82.50%, respectively. When the cut-off value of NLR is 3.62, the sensitivity and specificity are 85.00% and 77.50%, respectively. Conclusion The detection of NLR andMLR is helpful to judge the active stage and treatment effect of CD, provides basis for treatment, and can provide some basis for clinical diagnosis of CD.