中性粒细胞淋巴细胞比值和红细胞分布宽度对系统性红斑狼疮诊断价值的探讨
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摘要
目的探讨中性粒细胞淋巴细胞比值(NLR)和红细胞分布宽度(RDW-SD)在系统性红斑狼疮(SLE)诊断中的价值。方法选取62例SLE患者、80例其他风湿性疾病患者(原发性胆汁性肝硬化4例、强直性脊柱炎12例、类风湿性关节炎38例、干燥综合征9例、骨关节病11例、皮肌炎3例、系统性硬化病3例)和67例健康体检者,比较各组间免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、补体C3(C3)、补体C4(C4)、血沉(ESR)、抗核抗体(ANA)、抗双链DNA抗体(抗dsDNA抗体)、超敏C反应蛋白(CRP)、RDW-SD、中性粒细胞计数、淋巴细胞计数、NLR的差异,Spearman相关分析SLE患者RDW-SD、NLR与其他指标的关系,ROC曲线比较各指标的诊断性能。结果 SLE患者与其他风湿性疾病患者RDW-SD、NLR均高于健康对照组(P<0.05);SLE患者NLR与血沉正相关,相关系数为0.436(P <0.01),RDWSD与其他指标均无相关性(P>0.05);ROC曲线分析显示,ANA是本次研究涉及指标中诊断SLE的最有价值指标,AUC为0.905(P<0.0001)。结论 NLR与RDW-SD可以作为炎症反应指标,在SLE的诊断及疗效观察中有一定价值。
Objective To explore the values of neutrophil lymphocyte rate(NLR)and erythrocyte distribution width(RDW-SD)in the diagnosis of systemic lupus erythematosus(SLE). Methods We selected 62 cases of SLE patients,80 patients with other rheumatic diseases(4 cases of primary biliary cirrhosis, 12 cases of ankylosing spondylitis,38 cases of rheumatoid arthritis,9 cases of Sjogren's syndrome,11 cases of osteoarthrosis,3 cases of myositis,and 3 cases of systemic sclerosis)and 67 cases of healthy medical person as the different study groups.We then compared the differences of immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement C3(C3), complement C4(C4), erythrocyte sedimentation rate(ESR), antinuclear antibodies(ANA),double-stranded DNA antibody(dsDNA antibody),high-sensitivity C-reactive protein(CRP),RDW-SD,neutrophil count,lymphocyte count,and NLR among the three groups. We also analyzed the correlation among RDW,NLR and other indexes of SLE patients with Spearman correlation analysis, and compared the diagnostic performance of each index with the ROC curve. Results The values of RDW-SD and NLR of patients with SLE and other rheumatic diseases were higher than those of the healthy controls(P <0.05). In SLE patients,NLR was significantly correlated with ESR(P < 0. 01), with correlation coefficient 0. 436, while RDW-SD had no correlation with any other indexes(P >0.05).The ROC curve analysis showed that ANA was the most valuable index for the diagnosis of SLE in this study. With AUC value of 0. 905(P < 0. 0001). Conclusion NLR and RDW-SD can be used as indexes of inflammatory response,with promising values in the diagnosis and therapeutic effect of SLE.
Objective To explore the values of neutrophil lymphocyte rate(NLR)and erythrocyte distribution width(RDW-SD)in the diagnosis of systemic lupus erythematosus(SLE). Methods We selected 62 cases of SLE patients,80 patients with other rheumatic diseases(4 cases of primary biliary cirrhosis, 12 cases of ankylosing spondylitis,38 cases of rheumatoid arthritis,9 cases of Sjogren's syndrome,11 cases of osteoarthrosis,3 cases of myositis,and 3 cases of systemic sclerosis)and 67 cases of healthy medical person as the different study groups.We then compared the differences of immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement C3(C3), complement C4(C4), erythrocyte sedimentation rate(ESR), antinuclear antibodies(ANA),double-stranded DNA antibody(dsDNA antibody),high-sensitivity C-reactive protein(CRP),RDW-SD,neutrophil count,lymphocyte count,and NLR among the three groups. We also analyzed the correlation among RDW,NLR and other indexes of SLE patients with Spearman correlation analysis, and compared the diagnostic performance of each index with the ROC curve. Results The values of RDW-SD and NLR of patients with SLE and other rheumatic diseases were higher than those of the healthy controls(P <0.05). In SLE patients,NLR was significantly correlated with ESR(P < 0. 01), with correlation coefficient 0. 436, while RDW-SD had no correlation with any other indexes(P >0.05).The ROC curve analysis showed that ANA was the most valuable index for the diagnosis of SLE in this study. With AUC value of 0. 905(P < 0. 0001). Conclusion NLR and RDW-SD can be used as indexes of inflammatory response,with promising values in the diagnosis and therapeutic effect of SLE.
引文
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[13]刘萍.3578例ANA、dsDNA和ENA抗体谱联合检测结果分析[J].西南国防医药,2016,26(5):559-561.
[14]周之海,门剑龙.系统性红斑狼疮患者红细胞参数的分析[J].临床皮肤科杂志,1997,2:92-94.
[2] BHAT T,TELI S,RIJAL J,et al. Neutrophil to lymphocyte ratio and cardiovascular diseases:a review[J]. ExpertRev Cardiovasc Ther,2013,11(1):55-59.
[3] OEHADIAN A, SURYADINATA H, DEWI S, et al. The role of neutrophyl lymphocyte count ratio as anin flammatory marker in systemic lupus erythematosus[J]. Acta Med Indones,2013,45(3):170-174.
[4] XIAO W K,CHEN D, LI S Q, et al. Prognostic significance of neutrophil-lymphocyte ratio in hepatocellularcarcinoma:a metaanalysis[J].BMC Cancer,2014,14:117.
[5]盛春梅,马礼坤.红细胞分布宽度与冠心病关系的研究[J].安徽医学,2014,35(12):1667-1669.
[6]王鹏,吕卫华,刘和锦,等.老年脑梗死患者颈动脉粥样硬化斑块稳定性与红细胞分布宽度的关系[J].中华老年心脑血管病杂志,2013,15(5):488-491.
[7] CHIBA T,MARUSAWA H,USHIJIMA T. Inflammation-associated cancer development in digestiveorgans:mechanisms and roles for genetic and epigenetic modulation[J]. Gastroenterology, 2012,143(3):550-563.
[8] MLADENOVA D, KOHONEN-CORISH M R. Review:mouse models of inflammatory bowel disease-insights into the mechanisms of inflammation-associated colorectal cancer[J]. In Vivo,2012,26(4):627-646.
[9] SONG C S,PARK D I, YOON M Y,et al. Association between red cell distribution width and disease activity in patients with inflammatory bowel disease[J]. Dig Dis Sci, 2012, 57(4):1033-1038.
[10] HU Z D,SUN Y,GUO J, et al. Red blood cell distribution width and neutrophil lymphocyte ratio are positively correlated with disease activity in primarySjogren's syndrome[J]. Clin Biochem,2014,47(18):287-290.
[11]傅海涛,杨敏,黄凤楼,等.胆汁性肝硬化患者红细胞分布宽度的变化及其意义[J].检验医学,2015,30(9):871-873.
[12]葛均波,叙永健.内科学[M].第8版.北京:人民卫生出版社,2013:815.
[13]刘萍.3578例ANA、dsDNA和ENA抗体谱联合检测结果分析[J].西南国防医药,2016,26(5):559-561.
[14]周之海,门剑龙.系统性红斑狼疮患者红细胞参数的分析[J].临床皮肤科杂志,1997,2:92-94.