Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Immunol. 2022 Jul 1;13:911779. doi: 10.3389/fimmu.2022.911779. eCollection 2022.
The neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) are biomarkers that may reflect inflammatory status in some immune-related diseases. This study aims to investigate the association of NLR and MLR with the severity and prognosis of autoimmune encephalitis (AE).
A total of 199 patients diagnosed with AE in the First Affiliated Hospital of Zhengzhou University from October 2015 to October 2021 were retrospectively analyzed. The Clinical Assessment Scale for Autoimmune Encephalitis (CASE) and the modified Rankin Scale (mRS) were used to evaluate the severity of the patients at admission, and the patients were divided into mild group (CASE ≤ 4) and severe group (CASE ≥ 5) according to the CASE score. Poor prognosis was described as an mRS of 3 or more at 12 months. Binary logistic regression analysis was performed to assess risk factors for the severity and prognosis of AE.
NLR and MLR of severe group were significantly higher than that of mild group. NLR and MLR were positively correlated with the CASE score ( = 0.659, < 0.001; = 0.533, < 0.001) and the mRS score ( = 0.609, < 0.001; = 0.478, < 0.001) in AE patients. Multivariate logistic analysis showed that NLR (OR = 1.475, 95%CI: 1.211-1.796, < 0.001) and MLR (OR = 15.228, 95%CI: 1.654-140.232, = 0.016) were independent risk factors for the severity of AE. In addition, the CASE score and the mRS score were positively correlated ( = 0.849, < 0.001). Multivariate logistic analysis showed that the CASE at admission (OR = 1.133, 95%CI: 1.043-1.229, = 0.003) and age (OR = 1.105, 95%CI: 1.062-1.150, < 0.001) were independent risk factors for the poor prognosis of AE patients. The NLR and MLR at admission and whether they decreased after immunotherapy were not associated with the prognosis of AE patients ( > 0.05).
NLR and MLR, readily available and widespread inflammatory markers, were helpful for clinicians to monitor disease progression and identify potentially severe patients of AE early to optimize clinical treatment decisions.
中性粒细胞与淋巴细胞比值（NLR）和单核细胞与淋巴细胞比值（MLR）是一些免疫相关疾病中可能反映炎症状态的生物标志物。本研究旨在探讨 NLR 和 MLR 与自身免疫性脑炎（AE）严重程度和预后的关系。
回顾性分析 2015 年 10 月至 2021 年 10 月在郑州大学第一附属医院确诊的 199 例 AE 患者。采用自身免疫性脑炎临床评估量表（CASE）和改良 Rankin 量表（mRS）评估患者入院时的严重程度，根据 CASE 评分将患者分为轻症组（CASE≤4）和重症组（CASE≥5）。预后不良定义为 12 个月时 mRS 评分≥3 分。采用二元逻辑回归分析评估 AE 严重程度和预后的危险因素。
重症组的 NLR 和 MLR 明显高于轻症组。NLR 和 MLR 与 CASE 评分呈正相关（=0.659， < 0.001；=0.533， < 0.001）和 mRS 评分（=0.609， < 0.001；=0.478， < 0.001）。多因素逻辑分析显示，NLR（OR=1.475，95%CI：1.211-1.796， < 0.001）和 MLR（OR=15.228，95%CI：1.654-140.232， =0.016）是 AE 严重程度的独立危险因素。此外，CASE 评分和 mRS 评分呈正相关（=0.849， < 0.001）。多因素逻辑分析显示，入院时 CASE 评分（OR=1.133，95%CI：1.043-1.229， =0.003）和年龄（OR=1.105，95%CI：1.062-1.150， < 0.001）是 AE 患者预后不良的独立危险因素。入院时 NLR 和 MLR 以及免疫治疗后是否降低与 AE 患者的预后无关（>0.05）。
NLR 和 MLR 作为易于获得且广泛存在的炎症标志物，有助于临床医生监测疾病进展并早期识别潜在的 AE 重症患者，从而优化临床治疗决策。
