类风湿关节炎患者外周血中性粒细胞／淋巴细胞比率血小板／淋巴细胞比率和红细胞体积分布宽度与病情活动的相关性分析  

Correlations of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and red blood cell distr- ibution width with disease activity of rheumatoid athritis

作　　者：朱波[1] 朱丽华[1] 巴荣[1] 尤海燕[1] 阴晴[1] 

机构地区：[1]江苏大学附属医院检验科,镇江212001

出　　处：《中华风湿病学杂志》2016年第12期832-835,共4页Chinese Journal of Rheumatology

基　　金：国家自然科学基金（81373217,81301657）;江苏省自然科学基金青年基金（BK20130476）

摘　　要：目的探讨中性粒细胞／淋巴细胞比率（NLR）、血小板／淋巴细胞比率（PLR）和红细胞体积分布宽度（ROW）在RA病情活动性评估中的价值。方法收集82例RA患者的临床资料（关节肿胀数、压痛数）和实验室指标（血常规、ESR、CRP）数据，依据RA疾病活动性评分（DAs28）将RA分为活动期RA组和缓解期RA组，比较2组的NLR、PLR和RDW水平，并对NLR、PLR和RDW与DAS28、ESR及CRP行相关性分析。组间比较采用t检验和非参数检验，相关性分析采用Spearman检验。结果活动期RA组外周血NLR[（3．2±2．0）％]和PLR[（167±70）％]水平显著高于缓解期RA水平[分别为（2．4±0．9）％，（133±43）％]，差异有统计学意义（t=2．28和2．50，P=0．02和0．01），而RDW水平[（13．9±2．5）％和（13．9±2．4）％]。2组间差异无统计学意义（t=0．14，P=0．89），RA患者组RDW水平[（13．9±2．5）％]显著高于健康对照组[（13．2±0．5）％]，差异有统计学意义（t=2．74，P=0．0069）。RA患者NLR、PLR与DAS28（r=0．23，P=0．03；r=0．26，P=0．04）、ESR（r=0．28，P=0．03；r=0．43，P〈0．01）及CRP（r=0．33，P=0．006；r=0．41，P〈0．01）水半呈正相关，均有统计学意义，而RDW与这3项参数均无相关性（P均〉0．05）。受试者工作特征曲线分析表明，NLR和PLR评定RA病情活动的曲线下面积（AUC）分别为0．802和0．753，当cutoff值分别为2．86和143．05时，此时诊断RA活动的敏感性为0．66和0．63，特异性为0．72和0．65。结论NLR和PLR与RA病情活动存在相关关系，对RA疾病活动评估有一定价值。Objective To investigate the clinical value of neutrophil-to-lymphocyte ratio, platelet-to- lymphocyte ratio and red blood cell distribution width in discriminating disease activity of rheumatoid athritis. Methods Eighty-nine rheumatoid arthritis out-patients of the Affiliated Hospital of Jiangsu University from Jan. 2012 to Mar. 2013 were recruited into this study. The disease activity index, such as swollen joint count and tender joint count were made by rheumatologists, and laboratory parameters（blood cell analysis, erythroeyte sedimentation rate and C-reactive protein） were measured as well. The enrolled patients were divided into the active RA group and remission RA group based on the DAS28 definition. Differences of NLR, PLR and RDW among groups were analyzed by t test and relations between variables were assessed by Spearman correlation analysis. The t test, non-parametric test and Spearman analysis were used for statistical analysis. Results The levels of NLR （3.2±2.0, 2.4±0.9, respectively） and PLR （167±70, 133±43, respectively） in active RA group were higher than that of the RA remission group （t=2.28 and 2.50, P=0.02 and 0.01）. The level of RDW [（13.9±2.5）%, （13.9±2.4）%, respectively] was not significantly different between the active RA group and the RA remission group （t =0.14, P=0.89）. ＇However, compared with healthy controls, the level of RDW [（13.9±2.5）%, （13.2±0.2）%, respectively] was significantly increased in RA patients （t=2.74, P=0.006 9）. NLR and PLR were positively correlated with DAS28 （r=0.23, P=-0.03; r=0.26, P=0.04, respectively）, ESR （r=0.28,P=0.03; r=0.43, P〈0.01, respectively） and CRP （r=0.33, P=0.006; r=0.41, P〈0.01, respectively）. However, there was no association between RDW and DAS28 （r=0.01, P=0.93）, ESR （r=0.20, P=0.15） and CRP （r=0.05, P=0.71）. Areas under curve of receiver operating characteristic （ROC） for assessing disease activity of rheumatoid athritis by NLR and PLR were 0.802 and 0.753 res

关 键 词：关节炎 类风湿 中性粒/淋巴细胞比率 红细胞体积分布宽度 血小板/淋巴细胞比率 疾病活动性评分 

分 类 号：R593.22[医药卫生—内科学]