摘要
目的:探讨中性粒细胞计数与淋巴细胞计数比值(NLR)和血小板计数与淋巴细胞计数比值(PLR)对反应性关节炎(ReA)诊断效能及与疾病治疗的关系。方法:选取2018年1月至2021年12月山西白求恩医院风湿免疫科确诊的79例ReA患者为ReA组,92例健康体检者为健康对照组。比较ReA组与健康对照组的NLR、PLR、血常规、C反应蛋白(CRP)、红细胞沉降率(ESR),采用Spearman相关分析性ReA患者NLR、PLR与血常规、CRP、ESR的相关性,且通过绘制受试者工作特征曲线(ROC)评价NLR、PLR及在ReA的诊断价值。最后比较治疗前后单核细胞计数、淋巴细胞计数、CRP、ESR和NLR、PLR的变化。结果:ReA组NLR、PLR高于健康对照组,且感染<2周发病的ReA患者NLR、PLR高于感染≥2周发病者(P<0.05)。ReA组NLR、PLR与白细胞计数、中性粒细胞计数、单核细胞计数、CRP、ESR呈正相关,PLR与血小板计数呈正相关,NLR、PLR与淋巴细胞计数呈负相关(P<0.05)。根据ROC曲线,NLR诊断ReA的最佳截断值为3.41(敏感性为57.00%,特异性为96.70%,AUC=0.81),PLR诊断ReA的最佳截断值为140.58(敏感性为77.20%,特异性为77.20%,AUC=0.85),且NLR与PLR联合诊断的敏感性为78.80%,特异性为91.00%,AUC=0.85;而CRP诊断ReA的最佳截断值为8.16(敏感性为78.50%,特异性为100.00%,AUC=0.89),ESR诊断ReA的最佳截断值为19.50(敏感性为84.80%,特异性为96.70%,AUC=0.91),NLR、PLR联合诊断的效能高于NLR、PLR单一检测,而略低于CRP和ESR(Z=4、Z=3.58,P<0.05)。进一步比较ReA患者治疗前后,NLR、PLR显著减低(P<0.05)。结论:NLR、PLR可用于辅助诊断ReA,且对患者的感染史具有一定的指导意义。两者在反映治疗效果具有一定的临床价值,两者联合的诊断效果更好,但其诊断效果不如CRP和ESR。
Objective:To explore the diagnostic efficacy of neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)in reactive arthritis(ReA)and their relationship with disease treatment.Methods:Seventy-nine ReA patients diagnosed by the Rheumatology and Immunology Department of Shanxi Bethune Hospital from January 2018 to December 2021 were selected as the ReA group,and 92 healthy examinees were selected as the healthy control group.The NLR,PLR,blood routine,C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)between the ReA group and the healthy control group were compared.Spearman correlation analysis was used to analyze the correlation between NLR,PLR,blood routine,CRP,and ESR in ReA patients.NLR,PLR,and their diagnostic value in ReA patients were evaluated by drawing receiver operating characteristic(ROC).Finally,the changes in monocyte count,lymphocyte count,CRP,ESR,NLR,and PLR before and after treatment were compared.Results:The NLR and PLR of the ReA group were higher than those of the healthy control group,and the NLR and PLR of ReA patients infected for less than two weeks were higher than those infected for those infected for two or more than two weeks(P<0.05).In the ReA group,NLR and PLR were positively correlated with white blood cell count,neutrophil count,monocyte count,CRP and ESR,PLR was positively correlated with platelet count,and NLR and PLR were negatively correlated with lymphocyte count(P<0.05).According to the ROC,the optimal cutoff value for NLR diagnosis of ReA is 3.41(sensitivity is 57.00%,specificity is 96.70%,AUC=0.81),the optimal cutoff value for PLR diagnosis of ReA is 140.58(sensitivity is 77.20%,specificity is 77.20%,AUC=0.85),and the sensitivity for combined diagnosis of NLR and PLR is 78.80%,specificity is 91.00%,and AUC=0.85;the optimal cutoff value for CRP diagnosis of ReA is 8.16(sensitivity is 78.50%,specificity is 100.00%,AUC=0.89),and the optimal cutoff value for ESR diagnosis of ReA is 19.50(sensitivity is 84.80%,specificity is 96.70%,AUC=0.91).The efficacy of c
作者
胡君萍
温晓婷
张靖悦
彭思绫
黄金华
许珂
HU Jun-ping;WEN Xiao-ting;ZHANG Jing-yue;PENG Si-ling;HUANG Jin-hua;XU Ke
出处
《风湿病与关节炎》
2024年第5期14-19,26,共7页
Rheumatism and Arthritis
基金
国家自然科学基金项目(8220062850)
广西自治区卫生健康委自筹经费科研项目(Z-R20231938)
广西医科大学青年科学基金项目(GXMUYSF202333)。
