红细胞分布宽度和中性粒细胞/淋巴细胞比值在类风湿关节炎中的诊断价值  

Diagnostic value of red blood cell distribution width and neutrophil/lymphocyte ratio in rheumatoid arthritis

作　　者：张秋琴 尤剑彬 章良铭 黄程勇[1] ZHANG Qiu-qin;YOU Jian-bin;ZHANG Liang-ming;HUANG Cheng-yong(Department of Clinical Laboratory,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院检验科

出　　处：《中国当代医药》2019年第30期61-64,共4页China Modern Medicine

摘　　要：目的探讨红细胞分布宽度(RDW)和中性粒细胞/淋巴细胞比值(NLR)在诊断类风湿关节炎(RA)疾病中的临床意义。方法选取2016年1月~2018年12月福建省立医院收治的170例RA患者作为RA组,另选取同期于健康体检中心定期体检的131例健康人群作为健康对照组。比较两组的RDW、中性粒细胞(N)、淋巴细胞(L)、血小板计数(PLT)、单核细胞(M)、NLR、单核细胞/淋巴细胞比值(MLR)、血小板/淋巴细胞比值(PLR),记录RA患者不同抗核抗体(ANA)滴度(1∶100、1∶320和1∶1000)情况下的RDW、NLR,分析RA患者RDW、NLR与C-反应蛋白(CRP)和红细胞沉降率(ESR)的相关性,并通过受试者工作特征(ROC)曲线探讨RDW、NLR诊断RA的临床意义。结果RA组的RDW、N、PTL、M、NLR、MLR、PLR均明显高于健康对照组,L数量显著低于健康对照组,差异有统计学意义(P<0.01)。RA患者不同ANA滴度情况下的RDW、NLR比较,差异无统计学意义(P>0.05)。RDW与CRP成正相关(r=0.15,P<0.05),RDW与ESR无相关性(P>0.05)。NLR与CRP、ESR均成正相关(r=0.34,P<0.001;r=0.18,P<0.05)。RDW的曲线下面积(AUC)为0.89,对应的最佳诊断临界值为13.25,灵敏度为84.60%,特异度为77.10%,95%CI为0.86~0.93;NLR的AUC为0.83,其最佳临界值为2.25,灵敏度为77.10%,特异度为78.60%,95%CI为0.78~0.87。结论RDW和NLR在RA患者中均有明显的升高,两者在RA临床诊断上或许可当作一种潜在的辅助检测项目。Objective To investigate the clinical significance of red blood cell distribution width(RDW)and neutrophil/lymphocyte ratio(NLR)in the diagnosis of rheumatoid arthritis(RA)disease.Methods A total of 170 RA patients admitted to the Fujian Provincial Hospital from January 2016 to December 2018 were selected as the RA group,and another 131 healthy people who underwent regular physical examination at the health check-up center during the same period were selected as the healthy control group.The RDW,neutrophil(N),lymphocyte(L),platelet count(PLT),monocyte(M),NLR,monocyte/lymphocyte ratio(MLR),platelet/lymphocyte ratio(PLR)were compared in the two groups.The RDW,NLR for different antinuclear antibody(ANA)titers(1∶100,1∶320,and 1∶1000)in RA patients were recorded.The correlation between RDW,NLR and C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in RA patients was analyzed.The clinical significance of RDW and NLR in the diagnosis of RA was investigated by receiver operating characteristic(ROC)curve.Results The RDW,N,PTL,M,NLR,MLR and PLR in the RA group were significantly higher than those in the healthy control group,and the number of L was significantly lower than that in the healthy control group,with statistically significant differences(P<0.01).There were no significant differences in RDW and NLR in RA patients under different ANA titers(P>0.05).RDW was positively correlated with CRP(r=0.15,P<0.05),and RDW had no correlation with ESR(P>0.05).NLR was positively correlated with CRP and ESR(r=0.34,P<0.001;r=0.18,P<0.05).The area under the curve(AUC)of RDW was 0.89,the corresponding optimal diagnostic cutoff value was 13.25,the sensitivity was 84.60%,the specificity was 77.10%,and the 95% CI was 0.86-0.93.The AUC of NLR was 0.83,the optimal cutoff value was 2.25,the sensitivity was 77.10%,the specificity was 78.60%,and the 95% CI was 0.78-0.87.Conclusion Both RDW and NLR significantly increase in patients with RA,which may be regarded as potential auxiliary detection items in the clinical diagnosis

关 键 词：类风湿关节炎 红细胞分布宽度 中性粒细胞 淋巴细胞 

分 类 号：R556[医药卫生—血液循环系统疾病]