中性粒细胞/淋巴细胞、血小板/淋巴细胞比值是评价托法替尼治疗后类风湿关节炎活动性的有效指标

Neutrophil-lymphocyte and platelet-lymphocyte ratios for assessing disease activity in patients with rheumatoid arthritis receiving tofacitinib treatment

目的探讨接受托法替尼治疗的类风湿关节炎(RA)患者新兴炎症标志物中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)与炎症因子IL-6、疾病活动性的关系。方法选取2019~2021年在湘雅第三医院确诊的RA患者98例,健康对照100例。在托法替尼治疗前1个月和治疗后6个月采集血样,测定红细胞沉降率(ESR)、C反应蛋白(CRP)、白介素6(IL-6)及其他血液参数,评估托法替尼治疗前后RA患者的PLR和NLR,分析二者与RA疾病活动性指标的相关性。结果RA患者PLR、NLR较健康对照组明显升高。在托法替尼治疗之前与之后,PLR、NLR与超敏C反应蛋白(hs-CRP)、ESR、IL-6、DAS28-ESR值及RA生物标志物抗环瓜氨酸肽(CCP)和类风湿因子(RF)水平均呈正相关关系。与治疗前相比,RA患者接受托法替尼治疗6个月后hs-CRP、ESR、IL-6、CCP、RF和DAS28-ESR水平明显降低。结论NLR和PLR是评价托法替尼治疗后RA疾病活动性的有效指标。

Objective To evaluate the value of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)for assessing disease activity in patients with rheumatoid arthritis(RA)treated with tofacitinib.Methods This retrospective study was conducted among 98 RApatients in active stage treated with tofacitinib in Third Xiangya Hospital and 100 healthy control subjects from the Health Management Center of the hospital from 2019 to 2021.We collected blood samples from all the participants for measurement of erythrocyte sedimentation rate(ESR),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and other blood parameters 1 month before and 6 months after tofacitinib treatment.We further evaluated PLR and NLR before and after tofacitinib treatment in the RA patients,and analyzed their correlations with RA disease activity.Results PLR and NLR increased significantly in RApatients as compared with the healthy controls.In the RApatients,PLR and NLRwere positively correlated with the levels of hs-CRP,ESR,IL-6,Disease Activity Score of 28 joints-ESR(DAS28-ESR),anti-cyclic citrullinated peptide(CCP),and rheumatoid factor(RF)before and after tofacitinib treatment.Tofacitinib treatment for 6 months significantly decreased hs-CRP,ESR,IL-6,CCP,RF and DAS28-ESR levels in the RA patients.Conclusion NLR and PLR can be useful biomarkers for assessing disease activity inRApatients treated with tofacitinib.