中性粒细胞与淋巴细胞比值作为系统性红斑狼疮疾病活动的替代标志物：一项使用SLE-DAS的相关性研究
The neutrophil-to-lymphocyte ratio as a surrogate marker for disease activity in systemic lupus erythematosus: a correlation study using the SLE-DAS.
作者信息
Wong Mandy Ming Yan, Lam Fung, Mok Chi Chiu
机构信息
Department of Medicine, Tuen Mun Hospital, New Territories, Hong Kong.
Department of Medicine, Pok Oi Hospital, Hong Kong, Hong Kong.
出版信息
Ther Adv Musculoskelet Dis. 2025 Jun 19;17:1759720X251347272. doi: 10.1177/1759720X251347272. eCollection 2025.
BACKGROUND
The neutrophil-to-lymphocyte ratio (NLR) is a potential surrogate marker for disease activity in many rheumatic diseases.
OBJECTIVE
To study the correlation between NLR and disease activity of systemic lupus erythematosus (SLE) using the SLE disease activity score (SLE-DAS).
DESIGN
Retrospective, cross-sectional.
METHODS
Consecutive adult patients who fulfilled the American College of Rheumatology (ACR) or Systemic Lupus International Collaboration Clinic (SLICC) criteria for SLE were recruited between March 2023 and February 2024. SLE activity was assessed by physicians' global assessment (PGA), SLE-DAS, and SLE disease activity index-2000 (SLEDAI-2K). The calculated NLR was correlated with disease activity indices and serological parameters (anti-dsDNA, C3/4) by Spearman's rank correlation. Patients were stratified into SLE-DAS remission, mild, and moderate/severe disease activity, and a comparison of the NLR was performed among these subgroups by one-way ANOVA.
RESULTS
A total of 420 SLE patients were studied (93.1% women, age 31.6 ± 13.1 years, SLE duration 15.7 ± 8.1 years). Moderate/severe, mild disease activity and SLE-DAS remission were present in 70 (16.7%), 65 (15.5%), and 285 (67.9%) patients, respectively. SLE-DAS correlated significantly with SLEDAI-2K (rho 0.90; < 0.001) and PGA (rho 0.60; < 0.001). The mean NLR of all patients was 3.54 ± 4.0 and NLR correlated significantly with SLE-DAS (rho 0.17; < 0.001). The NLR was significantly higher in patients with active disease in the SLE-DAS renal domain than those in remission (5.17 ± 7.11 vs 3.22 ± 3.19; = 0.03). The NLR in patients with moderate/severe SLE-DAS activity (5.25 ± 6.89) was significantly higher than those with mild activity (3.12 ± 2.26; < 0.01) or remission (3.22 ± 3.19; < 0.01). ROC analysis showed that an NLR cut-off of 3.11 showed a sensitivity of 55.6% and specificity of 68.7% in detecting moderate/severe SLE-DAS activity (area under the curve 0.67 (0.6-0.7); < 0.001).
CONCLUSION
The NLR is a convenient marker that correlates significantly with disease activity in SLE.
背景
中性粒细胞与淋巴细胞比值（NLR）是许多风湿性疾病疾病活动度的潜在替代标志物。
目的
使用系统性红斑狼疮疾病活动评分（SLE-DAS）研究NLR与系统性红斑狼疮（SLE）疾病活动度之间的相关性。
设计
回顾性横断面研究。
方法
2023年3月至2024年2月期间，连续纳入符合美国风湿病学会（ACR）或系统性红斑狼疮国际协作组（SLICC）SLE标准的成年患者。通过医生整体评估（PGA）、SLE-DAS和系统性红斑狼疮疾病活动指数2000（SLEDAI-2K）评估SLE活动度。通过Spearman等级相关性分析计算得出的NLR与疾病活动指数及血清学参数（抗双链DNA、C3/4）之间的相关性。将患者分为SLE-DAS缓解、轻度和中度/重度疾病活动组，通过单因素方差分析比较这些亚组之间的NLR。
结果
共研究了420例SLE患者（93.1%为女性，年龄31.6±13.1岁，SLE病程15.7±8.1年）。分别有70例（16.7%）、65例（15.5%）和285例（67.9%）患者存在中度/重度、轻度疾病活动及SLE-DAS缓解。SLE-DAS与SLEDAI-2K（rho 0.90；P<0.001）和PGA（rho 0.60；P<0.001）显著相关。所有患者的平均NLR为3.54±4.0，且NLR与SLE-DAS显著相关（rho 0.17；P<0.001）。SLE-DAS肾脏领域有活动的患者的NLR显著高于缓解期患者（5.17±7.11 vs 3.22±3.19；P=0.03）。中度/重度SLE-DAS活动患者的NLR（5.25±6.89）显著高于轻度活动患者（3.12±2.26；P<0.01）或缓解期患者（3.22±3.19；P<0.01）。ROC分析显示，NLR临界值为3.11时，检测中度/重度SLE-DAS活动的敏感性为55.6%，特异性为68.7%（曲线下面积0.67（0.6 - 0.7）；P<0.001）。
结论
NLR是一种方便的标志物，与SLE疾病活动度显著相关。
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