Zhou Yongyan, Xie Haojie, Zhao Yi, Zhang Jinwei, Li Yanfei, Duan Ranran, Yao Yaobing, Jia Yanjie
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
Neuropsychiatr Dis Treat. 2021 May 18;17:1493-1503. doi: 10.2147/NDT.S311942. eCollection 2021.
To investigate the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the severity of neurological impairment at disease onset in patients with a first episode of neuromyelitis optica spectrum disorder (NMOSD).
This retrospective study included 259 patients with newly diagnosed NMOSD who were hospitalized at our institution between January 2013 and January 2020 (NMOSD group) and 169 healthy control subjects who underwent a physical examination at our hospital during the same period (control group). The clinical data collected included general information, past medical history, biochemical test results, imaging findings, NLR, AQP-4 antibody status, and initial Expanded Disability Status Scale score. A logistic regression model was used to analyze NLR as an independent risk factor for the severity of neurological impairment at disease onset in the NMOSD group. Receiver-operating characteristic curve analysis was used to evaluate the ability of the NLR to predict the severity of neurological impairment at disease onset in the NMOSD group and to determine its critical value.
The NLR was significantly higher in the NMOSD group than in the control group (<0.001). In the NMOSD group, neurological impairment at disease onset was more severe in those with a high NLR than in those with a low NLR (<0.001). At onset of disease, patients with severe neurological impairment had a more significant increase in NLR than those with mild-to-moderate neurological impairment (<0.001). Both univariate (OR 1.180, 95% CI 1.046-1.331, =0.007) and multivariate (OR 1.146, 95% CI 1.003-1.308, =0.044) logistic regression analyses showed that the NLR was positively correlated with the severity of neurological impairment at onset of disease in the NMOSD group. The area under the receiver-operating characteristic curve was 0.687.
The NLR is an independent risk factor for the severity of neurological impairment at disease onset in patients with a first episode of NMOSD.
探讨视神经脊髓炎谱系障碍（NMOSD）首次发作患者疾病发作时中性粒细胞与淋巴细胞比值（NLR）与神经功能缺损严重程度之间的关系。
本回顾性研究纳入了2013年1月至2020年1月在我院住院的259例新诊断的NMOSD患者（NMOSD组）以及同期在我院接受体检的169例健康对照者（对照组）。收集的临床资料包括一般信息、既往病史、生化检查结果、影像学检查结果、NLR、水通道蛋白4（AQP-4）抗体状态以及初始扩展残疾状态量表评分。采用逻辑回归模型分析NLR作为NMOSD组疾病发作时神经功能缺损严重程度的独立危险因素。采用受试者工作特征曲线分析评估NLR预测NMOSD组疾病发作时神经功能缺损严重程度的能力并确定其临界值。
NMOSD组的NLR显著高于对照组（<0.001）。在NMOSD组中，疾病发作时NLR高的患者神经功能缺损比NLR低的患者更严重（<0.001）。疾病发作时，神经功能缺损严重的患者NLR升高比轻度至中度神经功能缺损的患者更显著（<0.001）。单因素（比值比[OR]1.180，95%置信区间[CI]1.046 - 1.331，P = 0.007）和多因素（OR 1.146，95% CI 1.003 - 1.308，P = 0.044）逻辑回归分析均显示，NMOSD组疾病发作时NLR与神经功能缺损严重程度呈正相关。受试者工作特征曲线下面积为0.687。
NLR是NMOSD首次发作患者疾病发作时神经功能缺损严重程度的独立危险因素。
