NLR、NPR在评估溃疡性结肠炎疾病活动度中的临床价值

Clinical value of NLR and NPR for assessing disease activity in ulcerative colitis

目的分析中性粒细胞与淋巴细胞比值(NLR)、中性粒细胞与血小板比值(NPR)在评估溃疡性结肠炎(UC)活动度中的临床意义。方法收集2018年11月至2020年11月河北大学附属医院收治的129例UC患者,回顾性分析不同临床、内镜、组织学活动度及严重程度UC患者NLR、NPR、CRP、ESR水平差异变化;分析NLR、NPR与临床、内镜、组织学、常用炎症指标的相关性,并检测两者诊断UC的灵敏度、特异度及最佳阈值。结果随着临床、内镜、组织学活动度的增加,UC患者的ESR、CRP、NLR、NPR水平依次升高。NLR、NPR与Truelove-Witts评分、Mayo内镜评分、Nancy组织学指数均呈显著正相关(均P<0.01)。NLR、NPR与ESR、CRP也呈正相关(均P<0.01)。ROC曲线显示,NLR、NPR诊断UC的AUC分别为0.858(95%CI:0.806~0.900)和0.736(95%CI:0.674~0.791)。NLR诊断UC的最佳阈值为1.876,灵敏度和特异度分别为0.806和0.771,NPR诊断UC的最佳阈值为18.186,灵敏度和特异度分别为0.504和0.833。结论NLR、NPR作为易于获取的非侵入性指标,可作为临床诊断UC及评估疾病活动度的辅助指标。

Objective To analyze the clinical value of neutrophil to lymphocyte ratio(NLR)and neutrophil to platelet ratio(NPR)in assessing the disease activity of ulcerative colitis(UC).Methods One hundred and twenty-nine UC patients admitted to the Affiliated Hospital of Hebei University from November 2018 to November 2020 were enrolled.The NLR,NPR,CRP and ESR were measured and the correlation of NLR and NPR with clinical symptoms,inflammatory indicators,endoscopic and histological findings was analyzed.The value of NLR and NPR in diagnosis of UC was examined.Results With the increase of disease activity of UC patients,the ESR,CRP,NLR and NPR levels increased.The NLR and NPR were positively correlated with ESR and CRP levels,Truelove-Witts score,Mayo endoscopic score and Nancy histology index of UC patients(all P<0.01).The AUC of NLR and NPR for diagnosis of UC was 0.858(95%CI:0.806-0.900)and 0.736(95%CI:0.674-0.791),respectively.The optimal cutoff values of NLR and NPR for diagnosis of UC were 1.876 and 18.186,respectively;and the corresponding to sensitivity and specificity were 0.806,0.504 and 0.771,0.833,respectively.Conclusion NLR and NPR may be used for clinical diagnosis of UC and evaluation of disease activity,which deserve further clinical promotion.