中性粒细胞与淋巴细胞比值和淋巴细胞与单核细胞比值对类风湿关节炎合并间质性肺疾病的预测价值  

Predictive value of neutrophil to lymphocyte ratio and lymphocyte to monocyte ratio in rheumatoid arthritis with interstitial lung disease

作　　者：宋瑶 吴福顺[1] 韩勇[1] 崔丁鹿 崔新英 李雷 金京春[1] SONG Yao;WU Fushun;HAN Yong;CUI Dinglu;CUI Xinying;LI Lei;JIN Jingchun(Affiliated Hospital of Yanbian University,Yanji 133000,Jilin,China)

机构地区：[1]延边大学附属医院,吉林延吉133000

出　　处：《延边大学医学学报》2021年第2期111-115,共5页Journal of Medical Science Yanbian University

摘　　要：[目的]分析中性粒细胞与淋巴细胞比值(NLR)和淋巴细胞与单核细胞比值(LMR)对类风湿关节炎(RA)合并间质性肺疾病(ILD)的预测价值.[方法]回顾性分析2011年1月至2020年11月间接受住院治疗的118例RA患者的临床资料,按照是否合并有ILD分为非RA-ILD组和RA-ILD组,另选择同期行健康体检者118人作为正常对照组,比较各组一般临床资料、血液学指标、生物化学指标和免疫学指标,分析RA患者NLR和LMR与临床实验室其他指标的相关性,并评估它们对RA合并ILD的预测价值.[结果]118例RA患者中合并ILD者为53例(44.92%);非RA-ILD组与RA-ILD组平均年龄间差异有统计学意义(P<0.05).RA患者NLR显著高于正常对照组(P<0.05),而LMR显著低于正常对照组(P<0.05);RA-ILD组NLR、ESR、CRP均显著高于非RA-ILD组(P<0.05),而LMR显著低于非RA-ILD组(P<0.05).RA患者NLR与ESR(r=0.254,P=0.005)和CRP(r=0.278,P=0.002)呈正相关.NLR(OR 1.670,95%CI:1.192~2.338;P=0.003)是RA合并ILD的危险因素;LMR(OR 0.838,95%CI:0.622~1.128;P=0.244)、ESR(OR 1.008,95%CI:0.990~1.026;P=0.401)和CRP(OR 1.000,95%CI:0.988~1.013;P=0.971)不是RA合并ILD的危险因素.预测正常人患RA结果中,NLR的Cutoff值为2.190(敏感度70.3%,特异度77.1%,AUC=0.780),LMR的Cutoff值为3.460(敏感度50.0%,特异度79.7%,AUC=0.691);在预测RA合并ILD中,NLR的Cutoff值为2.885(敏感度75.5%,特异度69.2%,AUC=0.747),LMR的Cutoff值为3.120(敏感度58.5%,特异度78.5%,AUC=0.692).[结论]NLR、LMR可作为预测RA合并ILD的重要参数.OBJECTIVE To analyze the predictive value of neutrophil to lymphocyte ratio(NLR)and lymphocyte to monocyte ratio(LMR)in rheumatoid arthritis(RA)with interstitial lung disease(ILD).METHODS The clinical data of 118 patients with RA who hospitalized between January 2011 and November 2020 were retrospectively analyzed.They were divided into two groups according to whether ILD was incorporated:the non-RA-ILD group and the RA-ILD group.Another 118 healthy subjects who underwent physical examination at the same period were selected as normal control group.The general clinical data,hematological indexes,biochemical indexes and immunologic indexes of each group were compared.The correlation between NLR and LMR and other clinical laboratory indexes in RA patients was analyzed,and their predictive value for RA with ILD was evaluated.RESULTS Among 118 RA patients,53(44.92%)had ILD.There was significant difference in average age between non-RA-ILD group and RA-ILD group(P<0.05).NLR of the RA patients was significantly higher than that of the normal control group(P<0.05),and LMR was significantly lower than that of the normal control group(P<0.05).NLR,erythrocyte sedimentation rate(ESR)and C-reactive protein in the RA-ILD group were significantly higher than those in the non-RA-ILD group(P<0.05),while LMR was significantly lower than that in the non-RA-ILD group(P<0.05).NLR of the RA patients was positively correlated with ESR(r=0.254,P=0.005)and CRP(r=0.278,P=0.002).NLR(OR 1.670,95%CI:1.192-2.338;P=0.003)was a risk factor of RA with ILD.LMR(OR 0.838,95%CI:0.622-1.128;P=0.244),ESR(OR 1.008,95%CI:0.990-1.026;P=0.401)and CRP(OR 1.000,95%CI:0.988-1.013;P=0.971)were not risk factors of RA with ILD.In predicting RA in normal subjects,the Cutoff value of the NLR was 2.190(sensitivity 70.3%,specificity 77.1%,AUC=0.780),and the Cutoff value of the LMR was 3.460(sensitivity 50.0%,specificity 79.7%,AUC=0.691).In predict RA with ILD,the Cutoff value of the NLR was 2.885(sensitivity 75.5%,specificity 69.2%,AUC=0.747)and the Cutoff value o

关 键 词：类风湿关节炎 间质性肺疾病 中性粒细胞与淋巴细胞比值 淋巴细胞与单核细胞比值 预测价值 

分 类 号：R593.22[医药卫生—内科学]