Gao Sheng-Qiang, Huang Li-Dong, Dai Rui-Jie, Chen Dong-Dong, Hu Wei-Jian, Shan Yun-Feng
Departments of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University Zhejiang, P. R. China.
Int J Clin Exp Pathol. 2015 Nov 1;8(11):14779-85. eCollection 2015.
Peripheral blood-derived inflammation-based scores such as the neutrophil-lymphocyte ratio (NLR) have recently been proposed as prognostic markers in ulcerative colitis. In some previous serological markers are commonly used to detect the severity of the Crohn's disease (CD), but their sensitivity and specificity are relatively low. So we want to use simple indicators which are easy to obtain to predict disease severity. Now, we investigated and compared the capacity of NLR and other inflammatory markers in detecting CD activity and differentiating CD patients from healthy controls. These CD patients had not received corticosteroid or immunosuppressive drugs within a defined period of time. Data from our hospital between 2010 and 2012 was used. Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), platelet count and albumin were measured in 44 patients with active CD, 66 patients with inactive CD, and 55 healthy blood donors. Disease activity was assessed by the Crohn's Disease Activity Index. In the active CD group, NLR values were found to be elevated compared to inactive CD patients and controls (6.00±7.38, 5.53±6.18 and 1.84±0.85, respectively), but statistical difference was not found between active and inactive CD groups. The overall accuracy of NLR (cutoff: 2.13 fl), CRP (cutoff: 10.5 mg/dl), ESR (cutoff: 19.5 mm/hour) and WBC (cutoff: 9.2 × 10(9)/l) in differentiating CD patients from healthy controls was 80.9%, 67.3%, 71% and 60% respectively. NLR values were found to be correlated with WBC and CRP levels. NLR increased in CD patients compared with healthy subjects. NLR had the best accuracy in determination of CD patients and healthy controls. NLR did not show a discriminative value in disease activity.
外周血来源的基于炎症的评分，如中性粒细胞与淋巴细胞比值（NLR），最近被提议作为溃疡性结肠炎的预后标志物。在之前，一些血清学标志物常用于检测克罗恩病（CD）的严重程度，但其敏感性和特异性相对较低。所以我们想使用易于获取的简单指标来预测疾病严重程度。现在，我们研究并比较了NLR和其他炎症标志物检测CD活动以及区分CD患者与健康对照的能力。这些CD患者在规定时间内未接受过皮质类固醇或免疫抑制药物治疗。使用了我院2010年至2012年的数据。对44例活动期CD患者、66例非活动期CD患者和55名健康献血者测量了中性粒细胞与淋巴细胞比值（NLR）、C反应蛋白（CRP）、红细胞沉降率（ESR）、白细胞（WBC）、血小板计数和白蛋白。通过克罗恩病活动指数评估疾病活动度。在活动期CD组中，发现NLR值高于非活动期CD患者和对照组（分别为6.00±7.38、5.53±6.18和1.84±0.85），但活动期和非活动期CD组之间未发现统计学差异。NLR（临界值：2.13 fl）、CRP（临界值：10.5 mg/dl）、ESR（临界值：19.5 mm/小时）和WBC（临界值：9.2×10⁹/l）区分CD患者与健康对照的总体准确率分别为80.9%、67.3%、71%和60%。发现NLR值与WBC和CRP水平相关。与健康受试者相比，CD患者的NLR升高。NLR在确定CD患者和健康对照方面具有最佳准确率。NLR在疾病活动度方面未显示出鉴别价值。
