The Evaluation Value Of NLR And PLR In Peripheral Blood Of Patients With Rheumatoid Arthritis

Objective: To evaluate the levels of the neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR),and further to explore the potential relationship between these parameters and disease activity in patients with rheumatoid arthritis(RA).Then to analyze the clinical value of the parameters in disease activity stage,use of drugs,therapeutic effect and prognosis of RA patients.Methods: A retrospective study was used in this study.A total of 79 patients with RA who were outpatients and hospitalized in the department of rheumatology and immunology of Shaoxing Hospital of China Medical University from January 2018 to January 2021 were selected as research objects.52 healthy people were selected as the control group.Data including age,gender,tender joint count(TJC)in 28 joints,swollen joint count(SJC)in 28 joints,white blood cell count(WBC),neutrophil count,lymphocyte count,hemoglobin(HB),platelet(PLT)count,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)of RA patients were collected.Data of age,gender,white blood cell count,neutrophil count,lymphocyte count,hemoglobin,platelet count of healthy people were collected.NLR,PLR and 28 joint disease activity score(DAS-28)in the research objects and NLR,PLR in the control group were calculated.According to DAS-28 results,the research objects were divided into remission stage group,low activity stage group,moderate activity stage group and high activity stage group.The differences of blood routine indexes of each group were compared.Chi-square test was used for the comparison of classified variables between groups,Kruskal-Wallis H test or Mann-Whitney U test was used for the comparison of continuous variables,and Spearman rank correlation coefficient was used to evaluate the correlation between NLR,PLR and DAS-28.Results: According to DAS-28 score,among the 79 RA patients,37 were in the remission stage group,11 were in the low activity stage group,19 were in the moderate activity stage group,and 12 were in the high activity stage group.WBC count,neutrophil count,PLT count,NLR,PLR in peripheral blood of RA patients were higher than those in control group,while hemoglobin and lymphocyte count were lower than those in control group(P<0.05).NLR in the high activity stage group was higher than that of the remission stage group and the low activity stage group(P<0.05).NLR in the moderate activity stage group was higher than that in the remission stage group(P<0.05).PLR in the high activity stage group was higher than that in any subgroup(P<0.05).PLR in the moderate activity group was higher than that in the remission stage group(P <0.05).Spearman correlation analysis showed that there was a position correlation between NLR and DAS-28(r=0.472,P<0.0001),and there was a position correlation between PLR and DAS-28(r=0.529,P<0.0001).Conclusion: 1.NLR and PLR could be used to evaluate the disease activity for patients with RA to a certain extent.2.NLR and PLR were closely related to disease activity in RA patients.NLR and PLR were positively correlated with DAS-28 score,indicated that NLR and PLR had important clinical significance in disease activity stage,use of drugs,therapeutic effect and prognosis of RA patients.