| Background:Inflammatory bowel disease(IBD),mainly including Crohn’S disease(CD)and ulcerative colitis(UC),is a group of chronic immune disorders in intestine.IBD becomes a critical challenge in clinic with high frequency of relapse and poor prognosis.Patients with IBD suffer the disease with long term disease course,thus,it is urgent to develop clinical parameters to monitor disease activity of the patients.Currently,evaluation and diagnosis of IBD is performed by endoscopy and pathological examinations on biopsy,but those methods are costly and inconvenient to operate,and sometimes may have some complications such as bleeding,perforation,and poor patient compliance.Some other parameters of routine blood test including neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),and platelet to lymphocyte ratio(PLR)are associated with the pathogenesis of IBD and may be indicative of IBD disease activities,but the data from different groups exhibit high variation.The association between those parameters and IBD disease activities requires further studying.Objective:To study the correlation of routine blood test parameters including NLR,MLR,and PLR with disease activity of IBD patients.Method:The patients who were diagnosed with IBD for the first time in the Gastroenterology Department of our hospital from January 2016 to December 2020 were selected as the case group and divided into UC group(146 cases)and CD group(47 cases);UC group was divided according to the modified Mayo score Mild group(10 cases),moderate group(13 cases)and severe group(23 cases);CD group was divided into mild group(51 cases),moderate group(81 cases)and severe group(14cases).The above IBD patients meet the diagnostic criteria in the "Consensus on the Diagnosis and Treatment of Inflammatory Bowel Disease"(Beijing,2018).In addition,193 healthy people from the physical examination department of our hospital during the same period were selected as the normal control group.The age,height,weight,gender,and blood routine related indicators of the case group and the control group(including white blood cells,hemoglobin,platelets,neutrophil counts,Monocyte,lymphocyte count),Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),abdominal B-ultrasound or CT or MRI,endoscopy report and other indicators in the case group.Complete the grouping of the disease activity of the case group,compare the differences in the indicators between the IBD group and the control group,the UC group and the CD group,and compare the differences in the indicators between the mild,moderate and severe groups of UC and CD patients,including NLR,MLR,PLR;analyze the correlation between NLR,MLR,PLR and ESR,CRP.SPSS 25.0 statistical software was used for analysis and processing.After the measurement data are tested for the normal distribution or the homogeneity of variance,the continuous variables conforming to the normal distribution are used as the mean ± standard deviation(±s);the measurement data conforming to the skewed distribution use the median and interquartile range(25 % Quantile,75% quantile),using t test or rank sum test between groups;using Pearson or Spearman correlation analysis to determine the correlation between NLR,MLR,PLR and ESR,CRP;construct receiver operating characteristic curve(ROC curve),and calculate the area under the curve(AUC)and its 95% CI.P<0.05 indicates that the difference is statistically significant.Result:1.The NLR,MLR,and PLR of IBD patients were significantly higher than those of the control group.The NLR,MLR,and PLR of patients in the UC group and CD group were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).2.The NLR and PLR of CD patients were higher than those of the UC group,and the difference was not statistically significant.The MLR of patients in the UC group was higher than that of the CD group,and the difference was not statistically significant.3.The NLR,MLR,and PLR of the mild group and the moderate group of CD patients were significantly lower than those of the severe group,and the difference was statistically significant(P<0.05);the NLR of the mild group was lower than that of the moderate group,and the difference was not statistically significant Scientific significance;the MLR of the mild group was lower than that of the moderate group,and the difference was not statistically significant;the PLR of the mild group was significantly lower than that of the moderate group,and the difference was statistically significant(P<0.05).4.The NLR of the mild group of UC patients was lower than that of the moderate group,and the difference was not statistically significant.It was lower than that of the severe group,and the difference was statistically significant(P<0.05).The NLR of the moderate group was lower than that of the severe group,and the difference was not statistically significant.;The MLR of the mild group was lower than that of the moderate group and the severe group,and the difference was not statistically significant.The MLR of the moderate group was lower than the severe group,and the difference was not statistically significant;the PLR of the mild group was higher than that of the moderate group,and the difference was not statistically significant.Significance,lower than the severe group,the difference was not statistically significant,the PLR of the moderate group was lower than the severe group,the difference was statistically significant(P<0.05)5.NLR,MLR,and PLR in patients with IBD were significantly positively correlated with inflammation indicators ESR and CRP(P<0.01);NLR,MLR,and PLR in patients with CD were significantly positively correlated with inflammation indicators ESR and CRP(P<0.01);patients with UC NLR was positively correlated with inflammation index ESR(P<0.05),MLR,PLR and inflammation index ESR were significantly positively correlated(P<0.01),NLR,MLR and inflammation index CRP were significantly positively correlated(P<0.01),PLR and inflammation The index CRP was positively correlated(P<0.05).6.The AUCs of NLR for mild CD,moderate CD,and severe CD were 0.775,0.870,and 0.988,respectively.The sensitivity and specificity were 0.725,0.753,0.929 and 0.803,0.881,0.969.The AUC of MLR assessment of mild CD,moderate CD,and severe CD were 0.810,0.870,0.996,and the sensitivity and specificity were0.569,0.704,0.821 and 0.907,0.896,0.902,respectively.The AUC of PLR assessment of mild CD,moderate CD,and severe CD were 0.836,0.941,0.999,and the sensitivity and specificity were 0.686,0.840,0.920 and 0.943,0.948,0.956,respectively.7.The AUC of NLR assessment of mild UC,moderate UC,and severe UC were0.608,0.836,0.888,and the sensitivity and specificity were 0.800,0.692,0.708 and0.575,0.819,0.979,respectively.The AUC of MLR assessment of mild UC,moderate UC,and severe UC were 0.764,0.771,0.928,and the sensitivity and specificity were 0.700,0.769,0.875 and 0.798,0.725,0.938,respectively.The AUC of PLR assessment of mild UC was 0.790,0.701,0.914,and the sensitivity and specificity were 0.700,0.538,0.875 and 0.808,0.912,0.917,respectively.Conclusion:1.The NLR,MLR,and PLR of IBD patients are significantly higher than those of healthy people,and are related to ESR and CRP.2.The difference of PLR in CD with different disease activity is significant,and PLR can be used as an index to evaluate the disease activity of CD.Whether MLR and PLR can assess the disease activity of CD needs further research.PLR has high sensitivity and specificity in evaluating CD activity.3.Whether NLR,MLR,and PLR can assess the disease activity of UC needs further research. |
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