Li Peiji, Wu Yilin, Xiong Wei, Cao Jiahui, Chen Mengyun, Yuan Zhaowei, Guo Wenxin, Yang Bing
Shenzhen College of Clinical Medicine, Guangzhou University of Traditional Chinese Medicine, Shenzhen, Guangdong, 518000, China.
First School of Clinical Medicine, Guangzhou University of Traditional Chinese Medicine, Shenzhen, Guangdong, 510000, China.
BMC Gastroenterol. 2025 May 29;25(1):414. doi: 10.1186/s12876-025-04033-4.
Existing studies have explored the association between immune-inflammatory indices and inflammatory bowel disease (IBD), but there is a lack of comprehensive evidence. This meta-analysis and systematic review seeks to synthesize the data of available clinical research and offer the latest and comprehensive evidence-based conclusions regarding whether these immune-inflammatory indices can effectively predict the severity, activity, and prognosis of IBD.
Seven databases were comprehensively retrieved from their establishment to March 23, 2025. The combined results were described through standardized mean differences (SMD) or odds ratios (OR) with 95% confidence intervals (CI). Review Manager 5.4 and STATA 15.0 were leveraged for data analysis.
Our analysis included 35 studies involving 5,870 patients. The aggregated data revealed that the neutrophil-to-lymphocyte ratio (NLR) (OR = 1.18, 95% CI:1.04 to 1.34; P = 0.001) (SMD = 1.01, 95%CI = 0.73 to 1.29, P < 0.001), platelet-to-lymphocyte ratio (PLR) (SMD = 0.60, 95%CI = 0.46 to 0.74, P < 0.001), neutrophil-to-platelet ratio (NPR) (OR = 1.20, 95% CI:1.08 to 1.32, P < 0.001), and C-reactive protein to albumin ratio (CRP/ALB) (OR = 1.50, 95% CI:1.38 to 1.65, P < 0.001) were potentially linked to disease activity in IBD patients. PLR (SMD = 1.08, 95%CI = 0.60 to 1.55, P < 0.001) showed potential associations with disease severity in IBD patients. Additionally, NLR (SMD = 0.43, 95%CI = 0.15 to 0.70, P = 0.002) and eosinophil-to-lymphocyte ratio (ELR) (SMD = 0.63, 95%CI = 0.26 to 1.00, P < 0.001) had potential associations with endoscopic response in IBD patients. Moreover, NLR was potentially associated with disease relapse(OR = 1.35, 95% CI:1.09 to 1.68; P = 0.006) and steroid responsiveness (SMD = 0.50, 95%CI = 0.15 to 0.85, P = 0.005).
NLR, PLR, NPR, and CRP/ALB are potential predictors of disease activity in IBD patients. PLR shows the potential to predict disease severity, while NLR and ELR are potential indicators of endoscopic response. Furthermore, NLR is also a potential predictor of relapse and steroid responsiveness. Currently, there is insufficient evidence to support an association between NLR and the severity of IBD, whereas lymphocyte-to-monocyte ratio (LMR) appears to be associated with both the severity and activity of IBD and PLR and eosinophil*neutrophil-to-lymphocytes ratio (ENLR) are associated with endoscopic response in IBD.
CRD 42024609659.
现有研究已探讨免疫炎症指标与炎症性肠病（IBD）之间的关联，但缺乏全面证据。本荟萃分析和系统评价旨在综合现有临床研究数据，就这些免疫炎症指标能否有效预测IBD的严重程度、活动度及预后提供最新、全面的循证结论。
全面检索了7个数据库自建库至2025年3月23日的数据。合并结果通过标准化均数差（SMD）或比值比（OR）及95%置信区间（CI）进行描述。利用Review Manager 5.4和STATA 15.0进行数据分析。
我们的分析纳入了35项研究，涉及5870例患者。汇总数据显示，中性粒细胞与淋巴细胞比值（NLR）（OR = 1.18，95%CI：1.04至1.34；P = 0.001）（SMD = 1.01，95%CI = 0.73至1.29，P < 0.001）、血小板与淋巴细胞比值（PLR）（SMD = 0.60，95%CI = 0.46至0.74，P < 0.001）、中性粒细胞与血小板比值（NPR）（OR = 1.20，95%CI：1.08至1.32，P < 0.001）以及C反应蛋白与白蛋白比值（CRP/ALB）（OR = 1.50，95%CI：1.38至1.65，P < 0.001）可能与IBD患者的疾病活动度相关。PLR（SMD = 1.08，95%CI = 0.60至1.55，P < 0.001）显示出与IBD患者疾病严重程度的潜在关联。此外，NLR（SMD = 0.43，95%CI = 0.15至0.7，则P = 0.002）和嗜酸性粒细胞与淋巴细胞比值（ELR）（SMD = 0.63，95%CI = 0.26至1.00，P < 0.001）与IBD患者的内镜反应存在潜在关联。而且，NLR与疾病复发（OR = 1.35，95%CI：1.09至1.68；P = 0.006）及类固醇反应性（SMD = 0.50，95%CI = 0.15至0.85，P = 0.005）存在潜在关联。
NLR、PLR、NPR和CRP/ALB是IBD患者疾病活动度的潜在预测指标。PLR显示出预测疾病严重程度的潜力，而NLR和ELR是内镜反应的潜在指标。此外，NLR也是复发和类固醇反应性的潜在预测指标。目前，尚无足够证据支持NLR与IBD严重程度之间的关联，而淋巴细胞与单核细胞比值（LMR）似乎与IBD的严重程度和活动度均相关，PLR和嗜酸性粒细胞*中性粒细胞与淋巴细胞比值（ENLR）与IBD的内镜反应相关。
PROSPERO注册号：CRD 42（此处疑似有误，原文为CRD 42024609659）024609659 。
