Chen Yi, Wu Xue, Chen Xiaomei, Li Mengmeng, Luo Cainan, Shi Yamei, Li Jing, Wu Lijun
Department of Rheumatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China.
Xinjiang Rheumatoid Arthritis Clinical Medical Research Center, Urumqi, Xinjiang Uygur Autonomous Region, China.
Rheumatol Immunol Res. 2023 Dec 19;4(4):196-203. doi: 10.2478/rir-2023-0029. eCollection 2023 Dec.
We aimed to evaluate the correlations among the neutrophil-to-lymphocyte ratio (NLR), lupus nephritis (LN) clinical characteristics, and renal prognosis of patients with LN.
We enrolled 122 patients who were diagnosed with LN at the Rheumatology Department of the People's Hospital, Xinjiang Uygur Autonomous Region from January 2013 to April 2022. We determined the occurrence of renal adverse events in patients with LN by reviewing medical records and follow-up data. Correlations were analyzed using the Spearman test, and the quartile method was applied to classify all of the 122 patients who had completed follow-up into low, medium, and high NLR groups. The Kaplan-Meier survival curve was used to conduct survival analysis, and Cox regression analyses were used to explore possible potential risk factors.
The baseline NLR of patients with LN was positively correlated with C-reactive protein (CRP), serum creatinine, blood urea nitrogen, and systemic lupus erythematosus disease activity index scores ( < 0.05) and negatively correlated with estimated glomerular filtration rate (eGFR) and serum albumin ( < 0.05). Patients who completed follow-up were divided into three NLR groups based on their NLR values: 30 in the low (NLR ≤ 2.21), 62 in the medium (NLR > 2.21 and NLR ≤ 6.17), and 30 in the high NLR group (NLR > 6.17). The patient survival time before developing poor renal prognosis was significantly different among the three groups ( < 0.05). High NLR (hazard ratio [HR] = 3.453, 95% confidence interval [CI]: 1.260-9.464), CRP (HR = 1.009, 95% CI: 1.002-1.017), eGFR (HR = 0.979, 95% CI: 0.963-0.995), and 24-h proteinuria values (HR = 1.237, 95% CI: 1.025-1.491) as well as anti-double stranded DNA antibody positivity (HR = 3.056, 95% CI:1.069-8.736) were independent risk factors associated with a poor renal prognosis for patients with LN.
The baseline NLR in peripheral blood can be used as a reference index for evaluating renal function and disease activity in patients with LN, and a high NLR has predictive value for the prognosis of patients with LN.
我们旨在评估中性粒细胞与淋巴细胞比值（NLR）、狼疮性肾炎（LN）临床特征以及LN患者肾脏预后之间的相关性。
我们纳入了2013年1月至2022年4月在新疆维吾尔自治区人民医院风湿科确诊为LN的122例患者。通过查阅病历和随访数据确定LN患者肾脏不良事件的发生情况。采用Spearman检验分析相关性，并应用四分位数法将完成随访的122例患者分为低、中、高NLR组。采用Kaplan-Meier生存曲线进行生存分析，并用Cox回归分析探索可能的潜在危险因素。
LN患者的基线NLR与C反应蛋白（CRP）、血清肌酐、血尿素氮和系统性红斑狼疮疾病活动指数评分呈正相关（<0.05），与估计肾小球滤过率（eGFR）和血清白蛋白呈负相关（<0.05）。根据NLR值将完成随访的患者分为三个NLR组：低NLR组（NLR≤2.21）30例，中NLR组（NLR>2.21且NLR≤6.17）62例，高NLR组（NLR>6.17）30例。三组患者出现不良肾脏预后前的生存时间有显著差异（<0.05）。高NLR（风险比[HR]=3.453，95%置信区间[CI]：1.260-9.464）、CRP（HR=1.009，95%CI：1.002-1.017）、eGFR（HR=0.979，95%CI：0.963-0.995）、24小时蛋白尿值（HR=1.237，95%CI：1.025-1.491）以及抗双链DNA抗体阳性（HR=3.056，95%CI：1.069-8.736）是LN患者不良肾脏预后的独立危险因素。
外周血基线NLR可作为评估LN患者肾功能和疾病活动度的参考指标，高NLR对LN患者的预后具有预测价值。
