中性粒细胞与淋巴细胞比值、中性细胞与补体C3比值在评估系统性红斑狼疮疾病活动度中的应用  

Application of NLR and NC3R in assessing disease activity of systemic lupus erythematosus

作　　者：余建林[1] 吴洋[1] 曾婷婷[1] 田永建[1] 谭立明[1] 段新旺[2] 余乐 YU Jianlin;WU Yang;ZENG Tingting;TIAN Yongjian;TAN Liming;DUAN Xinwang;YULe(Department of Laboratory Medicine, Jiangxi Province Key Laboratory of Laboratory Medicine;Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China)

机构地区：[1]南昌大学第二附属医院检验科江西省检验医学重点实验室,南昌330006 [2]南昌大学第二附属医院风湿免疫科,南昌330006

出　　处：《临床检验杂志》2018年第7期490-492,共3页Chinese Journal of Clinical Laboratory Science

基　　金：国家自然科学基金(81760382);江西省自然科学基金(2017BAB205076);江西省教育厅科学技术研究项目(160157)

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)、中性粒细胞与补体C3比值(NC3R)在评估SLE疾病活动度中的价值。方法收集南昌大学第二附属医院SLE初诊患者共189例,包括高疾病活动度组42例、低疾病活动度组147例。电阻抗法检测中性粒细胞、淋巴细胞、单核细胞,免疫比浊法检测IgG、IgA、IgM、C3、C4水平;比较高、低疾病活动度组间NLR、NC3R及实验室指标的差异,并评价其与SLE活动度评分的相关性;ROC曲线分析其鉴别诊断高、低疾病活动度SLE的价值。结果高疾病活动度组与低疾病活动度组间的NC3R、NLR、C3、N、NC4R水平差异有统计学意义(P<0.05)。SLE活动度评分与NC3R(rs=0.367,P<0.01)、NLR(r_s=0.281,P<0.01)、NC4R(r_s=0.273,P<0.01)具有相关性。NC3R、NLR、NC4R诊断高活动度SLE的AUC分别为0.726、0.718、0.678;敏感性分别为0.690、0.500、0.619,特异性分别为0.741、0.857、0.755。结论 NC3R、NLR可以作为评估SLE疾病活动度的辅助指标。Objective To explore the value of neutrophil-to-lymphocyte ratio（ NLR） and neutrophils-to-C3 ratio（ NC3 R） for assessing the disease activity of systemic lupus erythematosus（ SLE）.Methods A total of 189 SLE patients who initially diagnosed in the Second Affiliated Hospital of Nanchang University were included in this study. Among the patients 42 cases were in severe disease activity group and 147 cases were in mild disease activity group. The count of neutrophils,lymphocytes and monocytes were determined by electric resistance assay. The levels of Ig G,Ig A,Ig M,C3 and C4 were determined by immunoturbidimetry. The differences of NLR,NC3 R and all the tested indicators between severe disease activity group and mild disease activity group were analyzed,and the correlations of NLR and NC3 R with SLE disease activity index（ SLEDAI） scores were analyzed. The ROC curve was used to assess their values in differential diagnosis of high and low disease activity. Results The levels of NLR,NC3 R,NC4 R,C3,neutrophils count between the high disease activity group and the low disease activity group showed differences（ P〈0.05）. SLEDAI scores were positively correlated with NC3 R（ rs= 0.367,P〈0.05）,NLR（ rs= 0.281,P〈0.05） and NC4 R（ rs= 0.273,P〈0.05）. The area under AUC of NC3 R,NLR and NC4 R in diagnosing highly active SLE was 0.726,0.718 and 0.678 respectively. The sensitivities were 0.690,0.500 and 0.619,and the specificities were 0.741,0.857 and 0.755,respectively. Conclusion NC3 R and NLR may be used as auxiliary indicators to assess the disease activity of SLE.

关 键 词：系统性红斑狼疮疾病活动度评分 系统性红斑狼疮 中性粒细胞与补体C3比值 中性粒细胞与淋巴细胞比值 

分 类 号：R446[医药卫生—诊断学]