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  • 景丽玲,刘云龙,郑杰,宋珊珊,裴开玮,陈燕.中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值诊断强直性脊柱炎的价值[J].第二军医大学学报,2019,40(7):754-758    [点击复制]
  • JING Li-ling,LIU Yun-long,ZHENG Jie,SONG Shan-shan,PEI Kai-wei,CHEN Yan.Clinical value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in diagnosis of ankylosing spondylitis[J].Acad J Sec Mil Med Univ,2019,40(7):754-758   [点击复制]
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中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值诊断强直性脊柱炎的价值
景丽玲1△,刘云龙2△,郑杰1,宋珊珊1,裴开玮1,陈燕1*
0
(1. 海军军医大学(第二军医大学)长海医院实验诊断科, 上海 200433;
2. 上海中医药大学附属曙光医院宝山分院急诊科, 上海 201900
共同第一作者
*通信作者)
摘要:
目的 评估中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)在强直性脊柱炎(AS)诊断中的价值。方法 纳入海军军医大学(第二军医大学)长海医院收治的AS患者80例(AS组)及健康体检者100例(健康对照组)作为研究对象。采集研究对象清晨空腹静脉血进行血常规检查并计算NLR和PLR,比较两组NLR和PLR的差异,采用受试者工作特征(ROC)曲线评价NLR、PLR诊断AS的灵敏度和特异度并进行联合诊断试验。结果 与健康对照组相比,AS组NLR、PLR均增高,差异均有统计学意义[2.25(1.66,3.35)vs 1.50(1.23,2.09),P<0.01;147.94(104.11,188.80)vs 105.75(89.55,148.02),P<0.01]。ROC曲线分析显示,NLR诊断AS的曲线下面积(AUC)为0.694[95%置信区间(CI):0.615~0.772,P<0.01],以最佳截断值(1.64)为诊断标准时其灵敏度和特异度分别为77.5%和58.0%;PLR诊断AS的AUC为0.662(95%CI:0.580~0.756),以最佳截断值(120.91)为诊断标准时其灵敏度和特异度分别为66.2%和63.0%。联合诊断试验结果显示,NLR与PLR并联试验(NLR/PLR)诊断AS的灵敏度和特异度分别为83.8%和50.0%,NLR与PLR串联试验(NLR+PLR)诊断AS的灵敏度和特异度分别为61.2%和75.0%。结论 NLR和PLR对AS具有一定的诊断价值,二者联合诊断可提高诊断的灵敏度和特异度。
关键词:  强直性脊柱炎  中性粒细胞与淋巴细胞比值  血小板与淋巴细胞比值  诊断
DOI:10.16781/j.0258-879x.2019.07.0754
投稿时间:2019-02-08修订日期:2019-06-21
基金项目:
Clinical value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in diagnosis of ankylosing spondylitis
JING Li-ling1△,LIU Yun-long2△,ZHENG Jie1,SONG Shan-shan1,PEI Kai-wei1,CHEN Yan1*
(1. Department of Laboratory Medicine, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Emergency, Baoshan Branch of Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201900, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To assess the clinical value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in diagnosis of ankylosing spondylitis. Methods Eighty patients with ankylosing spondylitis and 100 normal controls from Changhai Hospital, Naval Medical University (Second Militaray Medical University) were enrolled in our study. The fasting venous blood samples were collected in the morning for routine blood examination. The differences of NLR and PLR between the two groups were analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of NLR and PLR, and combined diagnostic test was performed. Results The levels of NLR and PLR in ankylosing spondylitis patients were significantly higher than those in the control group (2.25[1.66, 3.35] vs 1.50[1.23, 2.09], P<0.01; 147.94[104.11, 188.80] vs 105.75[89.55, 148.02], P<0.01]. ROC curve analysis showed that the area under curve (AUC) of NLR in diagnosis of ankylosing spondylitis was 0.694 (95% confidence interval[CI]:0.615-0.772, P<0.01), and the sensitivity and specificity of NLR were 77.5% and 58.0%, respectively, when the cut-off value was 1.64. The AUC of PLR in diagnosis of ankylosing spondylitis was 0.662 (95% CI:0.580-0.756), and the sensitivity and specificity of PLR were 66.2% and 63.0%, respectively, when the cut-off value was 120.91. The sensitivity and specificity of NLR and PLR parallel testing (NLR/PLR) were 83.8% and 50.0%, and the sensitivity and specificity of the NLR and PLR tandem testing (NLR+PLR) were 61.2% and 75.0%, respectively. Conclusion NLR and PLR both have clinical value for the diagnosis of ankylosing spondylitis, and the combination of the two can improve the diagnostic sensitivity and specificity.
Key words:  ankylosing spondylitis  neutrophil to lymphocyte ratio  platelet to lymphocyte ratio  diagnosis