NLR、MLR在溃疡性结肠炎中的临床意义

背景:外周血白细胞或白细胞分类作为临床检查的常规项目,被认为是炎症性疾病的简捷生物学标志物,中性粒细胞和外周血单核细胞与多种疾病的活动度和严重程度密切相关。目的:探讨外周血中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)在溃疡性结肠炎(UC)中的临床意义。方法:收集2017年10月—2019年7月郑州大学第二附属医院收治的62例UC患者,以42名健康体检者作为对照组。比较两组中性粒细胞计数、单核细胞计数、淋巴细胞计数、NLR、MLR,并分析其与C反应蛋白(CRP)、红细胞沉降率(ESR)、Mayo评分、UCEIS评分之间的相关性。ROC曲线分析各指标诊断UC的效能。结果:UC患者中性粒细胞计数、单核细胞计数、NLR以及MLR显著高于对照组(P 0. 05),淋巴细胞计数显著低于对照组(P 0. 05)。与轻度患者相比,中重度UC组中性粒细胞计数、单核细胞计数、NLR以及MLR显著升高(P 0. 05),淋巴细胞计数显著降低(P 0. 05)。中性粒细胞计数、单核细胞计数、NLR以及MLR与CRP、ESR、Mayo评分、UCEIS评分均存在正相关性,淋巴细胞计数与上述指标呈负相关性(P 0. 05)。Cut-off值为0. 470时,NLR诊断UC的敏感性为0. 613,特异性为0. 857,AUC为0. 731(95%CI:0. 636～0. 827); cut-off值为0. 439时,MLR诊断UC的敏感性为0. 629,特异性为0. 810,AUC为0. 726(95%CI:0. 630～0. 822)。结论:NLR和MLR在UC患者中升高,且可反映疾病活动状况,有望成为诊断和评估UC的血清学标志物。     

早期中性粒细胞与淋巴细胞比值对急性脑梗死面积的预测价值

目的探讨外周血早期中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)对急性脑梗死面积的预测价值。方法回顾性分析24h内入院的首次发作前循环脑梗死患者113例,根据头颅CT或MRI的脑梗死面积大小将患者分为腔隙性脑梗死组42例、中等面积脑梗死组40例和大面积脑梗死组31例。记录患者年龄、性别、既往史等一般临床资料以及发病24h内的血常规结果,计算NLR并进行统计学分析。结果 3组在年龄、糖尿病、白细胞计数、中性粒细胞绝对值、淋巴细胞绝对值、NLR和血红蛋白等方面比较,差异有统计学意义(P<0.05,P<0.01)。白细胞计数、中性粒细胞绝对值、NLR和淋巴细胞绝对值对大面积脑梗死预测的曲线下面积分别为0.669、0.740、0.802和0.744,其中NLR、中性粒细胞绝对值的曲线下面积与白细胞计数比较,差异有统计学意义(P<0.05)。NLR预测大面积脑梗死最佳界值为3.940,预测大面积脑梗死的敏感性和特异性分别为80.6%和78.0%。结论外周血早期NLR对大面积脑梗死有一定的预测价值。     

中性粒细胞与淋巴细胞比值与老年女性冠状动脉病变严重程度的相关性研究

目的研究老年女性急性冠状动脉综合征(ACS)患者中性粒细胞与淋巴细胞比值(NLR)与冠状动脉病变严重程度的相关性。方法选取2018年1月～2019年1月于泰达国际心血管病医院住院行冠状动脉造影检查的老年女性ACS患者241例为实验组,其中低NLR患者(NLR≤3.87)106例,高NLR患者(NLR3.87)135例,根据Gensini评分中位数法将入选者进一步分为高评分组(Gensini评分≥40分)120例和低评分组(Gensini评分40分)121例。另选择同期以胸痛入院行冠状动脉造影检查正常者180例为对照组。收集入选者一般资料,计算NLR。采用Spearman相关分析,采用ROC曲线分析NLR对ACS患者冠状动脉病变严重程度预测能力。结果实验组糖尿病比例、中性粒细胞、NLR、单核细胞明显高于对照组,淋巴细胞和HDL-C水平明显低于对照组(P=0.000)。高评分组中性粒细胞、NLR、中性粒细胞/单核细胞比值明显高于低评分组,淋巴细胞明显低于低评分组(P=0.000)。Spearman相关分析显示,老年女性ACS患者中性粒细胞、NLR、中性粒细胞/单核细胞比值与Gensini评分呈正相关,淋巴细胞与Gensini评分呈负相关(P=0.000)。老年女性ACS患者淋巴细胞、NLR是Gensini评分的危险因素(P0.01)。NLR预测老年女性ACS高Gensini评分的ROC曲线下面积为0.895(95%CI:0.856～0.935,P0.01),最佳临界值为3.87。高NLR患者急性左心衰竭发生率明显高于低NLR患者(8.1%vs 1.9%,P0.05)。结论 NLR对老年女性ACS患者冠状动脉病变严重程度具有一定的预测价值。     

外周血中性粒细胞淋巴细胞比值在甲状腺结节良恶性鉴别诊断中的应用

目的探讨术前外周血中性粒细胞淋巴细胞比值(NLR)在甲状腺结节良恶性鉴别诊断中的应用。方法甲状腺癌患者136例,甲状腺良性结节患者30例,所有病例均经手术病理证实,分析两组术前外周血NLR,并比较甲状腺癌有颈部淋巴结转移者与无淋巴结转移者的NLR。结果甲状腺恶性结节患者NLR高于良性结节组,有颈部淋巴结转移患者NLR高于无淋巴结转移者。结论术前外周血NLR对于甲状腺结节良恶性的鉴别诊断有一定的指导意义,并对甲状腺癌有无颈部淋巴结转移有一定的诊断价值。     

急性胰腺炎流行病学及严重性预测评估研究进展

流行病学显示急性胰腺炎(acute pancreatitis,AP)的发病率有所增加。依据修订的Atlanta分类标准,分为轻、中、重型AP,其严重性的预测方法有急性胰腺炎床旁严重性指标评分(BISAP)、急性胰腺炎胰腺外炎症CT评分(EPIC)及外周血中性粒细胞与淋巴细胞比值(NLR)等。     

急性STEMI患者术前梗死相关动脉血流异常预测因素

目的探讨经皮冠状动脉介入(PCI)治疗的急性ST段抬高型心肌梗死(STEMI)患者术前梗死相关动脉血流异常的预测因素。方法连续选取2014年12月～2016年6月于西安市第五医院行PCI治疗的急性STEMI患者116例,根据冠脉造影及TIMI分级示血流有无异常分为试验组(血流异常)和对照组(血流无异常),试验组99例,对照组17例,观察记录患者的年龄、身高、体重、病程等基本信息,行彩超、心电图检查及生化检测,计算患者入院时中性粒细胞与淋巴细胞计数比值(NLR)。结果试验组患者淋巴细胞计数低于对照组,中性粒细胞计数、白细胞计数、中性粒细胞与淋巴细胞比值、空腹血糖、吸烟率高于对照组,差异具有统计学意义(P0.05);对变量NLR、LVEL、白细胞计数、淋巴细胞计数、中性粒细胞计数、吸烟、空腹血糖进行多元Logistic回归分析,NLR和空腹血糖是PCI术前梗死相关动脉血流异常的独立危险因素,差异具有统计学意义(P0.05)。结论 STEMI患者空腹血糖及中性粒细胞/淋巴细胞比值(NLR)可作为行患者术前梗死相关动脉血流是否正常的预测指标。     

中性粒细胞/淋巴细胞比值与急性冠脉综合征的相关性

目的 探讨血清中性粒细胞/淋巴细胞比值（NLR）与急性冠脉综合征（ACS）的相关性。 方法 冠心病的患者254例,其中不稳定型心绞痛（UAP）患者122例,急性心肌梗死（AMI）患者132例,另取53例冠状动脉造影阴性患者为对照组。检测外周血白细胞计数及其分类计数,并计算NLR,比较3组一般临床资料、NLR及其他炎性指标与冠心病的相关性及严重程度的关系。 结果 与对照组比较,UAP组NLR、中性粒细胞计数明显升高,差异有统计学意义（P<0.05）,AMI组白细胞计数、中性粒细胞计数、NLR明显升高,差异有统计学意义（P<0.05）。多因素logistic回归分析显示NLR（OR 9.398,95% CI 1.352~3.934,P<0.05）是ACS的独立危险因素。相关性分析显示NLR水平与Gensini积分呈正相关,r=0.753,P<0.05。 结论 NLR与冠心病相关联,而且与病情严重程度相关。     

中性粒细胞/淋巴细胞比值、NIHSS评分和侧支循环Tan评分联合预测前循环大血管闭塞性卒中患者静脉溶栓转归

目的:探讨溶栓前外周血中性粒细胞/淋巴细胞比值（neutrophil to lymphocyte ratio, NLR）、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale, NIHSS）评分联合侧支循环Tan评分对急性前循环大血管闭塞性卒中患者静脉溶栓转归...     

2型糖尿病合并非酒精性脂肪肝与中性粒细胞/淋巴细胞比值的关系

目的讨论2型糖尿病患者合并非酒精性脂肪肝与中性粒细胞/淋巴细胞比值的关系。方法选取117例新诊断的2型糖尿病(T2DM)患者,其中未合并非酒精性脂肪肝(NAFLD)组56例,合并NAFLD组61例。比较两组间年龄、病程、体重指数(BMI)、空腹血糖(FBG)、空腹胰岛素(INS)、糖化血红蛋白(Hb Alc)、中性粒细胞、淋巴细胞、中性粒细胞/淋巴细胞比值(NLR)、超敏C反应蛋白(hs CRP)等指标。结果 NAFLD组INS、HOMA-IR、N及NLR均高于对照组,差异有统计学意义(P0.05);多因素逐步回归分析结果显示BMI、NLR是NAFLD的独立危险因素。结论 BMI、NLR是T2DM患者合并NAFLD的独立危险因素,NLR比值变化可作为判断T2DM患者合并NAFLD胰岛素抵抗严重程度的简易指标。     

血小板/淋巴细胞比值和中性粒细胞/淋巴细胞比值与肝衰竭预后相关性研究

目的探究外周血中血小板/淋巴细胞比值(platelet-lymphocyte ratio,PLR)和中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)在嗜肝病毒导致的肝衰竭疾病进展及预后中的临床意义。方法回顾性分析徐州医科大学附属医院电子病历系统数据,纳入2016年1月至2017年12月于我院感染性疾病肝病科住院的嗜肝病毒感染导致的肝衰竭患者共168例,进行PLR、NLR与预后相关性研究。结果 NLR、PLR在肝衰竭预后中均有预测价值,NLR预测价值优于PLR。入院时合并感染、乙肝病毒感染、戊肝病毒感染、治疗过程中并发感染患者所占比例及中性粒细胞(N)、NLR、INR、TBiL在未好转组均明显高于好转组,差异有统计学意义(P0.05)。淋巴细胞(L)、PTA、ALB好转组均明显高于未好转组,差异有统计学意义(P0.05)。各种临床类型患者所占比例差异有统计学意义(P0.05)。结论 PLR和NLR预测在嗜肝病毒导致的肝衰竭预后中有一定的指示作用,且NLR预测效果优于PLR。     

Value of hematological indices versus VEGF as biomarkers of activity in Behçet’s disease

Clinical Rheumatology - The aim of this study is to investigate the value of several hematological indices, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), red blood...     

外周血NLR、nCD64在HBV相关ACLF继发感染和短期预后中的诊断及预测价值

目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)、中性粒细胞CD64(nCD64)在乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)继发感染和短期预后中的诊断及预测价值。方法回顾性分析2018年7月至2020年7月承德医学院附属医院收治的85例HBV-ACLF患者临床资料,根据是否继发感染分为感染组45例及非感染组40例;根据治疗3个月后的短期预后将感染组患者分为好转组(29例)及未好转组(16例)。采集所有患者入院24 h内的外周血检测NLR、nCD64水平。采用受试者工作特征曲线分析外周血NLR、nCD64联合检测对HBV-ACLF继发感染的诊断价值及短期预后预测价值。结果感染组患者外周血NLR为(10.33±3.16)%、nCD64为(74.41±19.06)%,均高于非感染组患者的(6.53±1.14)%和(43.49±13.27)%,差异均有统计学意义(t=7.197、8.575,均P<0.01)。ROC曲线显示,外周血NLR、nCD64对HBV-ACLF继发感染具有一定诊断价值(AUC=0.756、0.789,P<0.01),且两项联合(AUC=0.837,P<0.01)诊断价值较高。好转组患者外周血NLR为(9.24±2.46)%、nCD64为(72.67±15.71)%,明显低于未好转组患者的(11.54±3.11)%和(85.89±12.43)%,差异有统计学意义(t=2.731、2.898,P=0.009、0.006)。ROC曲线显示,外周血NLR、nCD64对HBV-ACLF继发感染短期预后具有一定预测价值(AUC=0.784、0.765,P<0.01),且两项联合(AUC=0.823,P<0.01)预测价值较高。结论外周血NLR、nCD64可作为HBV-ACLF继发感染的诊断及评估短期预后的指标,且两项联合检测价值更高。     

The Relationship Between Neutrophil Lymphocyte Ratio and Non-dipper Hypertension

Non-dipper hypertension is associated with increased cardiovascular morbidity and mortality. Neutrophil/lymphocyte ratio (NLR) has been associated with poor outcomes in patients with cardiovascular diseases. However, little is known about the role of NLR in patients with non-dipper hypertension. In this study, NLR between dipper and non-dipper hypertensive patients was compared.This study included 80 hypertensive patients. Hypertensive patients were divided into two groups: 50 dipper patients (29 male, mean age 51.5 ± 8 years) and 30 non-dipper patients (17 male, mean age 50.6 ± 5.4 years). Transthoracic echocardiography and ambulatory 24-hour blood pressure monitoring were performed on all patients. No patient had a recent history of an acute infection or an inflammatory disease. Baseline NLR was measured by dividing neutrophil count to lymphocyte count. No statistically significant difference was found between the two groups in terms of basic characteristics. Mean NLR was significantly higher among persons with non-dipper compared with dipper patients (3.1 ± 0.95 vs. 1.8 ± 0.52, P < .001). Additionally, leukocytes and monocytes counts were higher in patients with non-dipper hypertension.In conclusion, our results suggest that higher NLR, an emerging marker of inflammation, has a positive correlation with blood pressure and is elevated in non-dippers compared with dippers.     

Comparison of inflammation-related hematologic indices for predicting metabolic syndrome in adults

International Journal of Diabetes in Developing Countries - It was planned to evaluate different hematologic indices (neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR),...     

Three new inflammatory markers C reactive protein to albumin ratio,neutrophil to lymphocyte ratio,and platelet to lymphocyte ratio correlated with relapsing polychondritis disease activity index

Clinical Rheumatology - The novel inflammatory markers C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) were associated with...     

Increased Neutrophil to Lymphocyte Ratio in Patients With Resistant Hypertension

Resistant hypertension (RHT) is an important disease that causes an increase in cardiovascular risk, yet its etiology remains unclear. The authors aimed to investigate neutrophil/lymphocyte ratio (NLR) as an inflammation marker in patients with RHT. A total of 150 patients were included in the study and grouped according to their office and ambulatory blood pressure measurements. They were classified as having normotension (NT), controlled hypertension (CHT), or RHT. The RHT group had a significantly higher NLR than the CHT group (P=.03), and NLRs of both hypertension groups were significantly higher than those in the NT group (P<.001, for both). NLR and neutrophil count were found to be independent correlates for RHT in multivariate analysis (P<.001). NLR and neutrophil count are increased in RHT patients than both CHT and NT patients. This finding, which is defined for the first time in patients with RHT, may imply the importance of inflammation in blood pressure control.     

Evaluation of hematological parameters in children with FMF

Clinical Rheumatology - In this study, we aimed to investigate whether neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV) might be helpful in the...     

中性粒细胞与淋巴细胞比值预测急性脑出血患者转归

目的 探讨外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)对急性脑出血患者转归的预测价值.方法 连续纳入经头颅CT确诊为脑出血的住院患者.采用改良Rankin量表(modified Rankin Scale,mRS)评估90 d时功能转归,0～2分定义为转归良好,3～6分定义为转归不良,6分为死亡.单变量分析比较组间人口统计学特征、基线资料、影像学和实验室检查结果.应用多变量logistic回归分析确定NLR与转归的独立相关性,受试者工作特征(receiver operating characteristic,ROC)曲线分析评价NLR对转归的预测价值.结果 共纳入205例急性脑出血患者,其中107例(52.2％)转归不良,57例(27.8％)死亡.转归不良组患者年龄(P=0.038)、格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分(P=0.001)、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分(P=0.001)、中性粒细胞计数(P=0.015)、淋巴细胞计数(P=0.002)、NLR(P=0.001)、空腹血糖(P=0.012)、超敏C反应蛋白(P=0.002)、血肿体积(P=0.005)以及血肿破入脑室的患者比例(P=0.004)与转归良好组差异均有统计学意义.死亡组患者年龄(P=0.002)、既往卒中史(P=0.018)、GCS评分(P=0.001)、NIHSS评分(P=0.001)、中性粒细胞计数(P=0.008)、淋巴细胞计数(P=0.001)、NLR(P =0.001)、空腹血糖(P=0.016)、血肿体积(P=0.001)以及血肿破入脑室的患者比例(P=0.002)与生存组差异均有统计学意义.多变量logistic回归分析显示,校正混杂因素后NLR是转归不良[优势比(odds ratio,OR) 2.405,95％可信区间(confidence interval,CI)1.613 ～ 3.587;P=0.001]和死亡(OR 2.268,95％ CIl.532～ 3.358;P=0.001)的独立预测因素.ROC曲线分析表明,NLR对90 d时转归不良有较高的预测价值(ROC曲线下面积0.703,95％ CI0.632 ～ 0.774;P ＜0.001),当截断值为2.3时敏感性和特异性分别为61.7％和72.4％;NLR对90 d内死亡也具有预测价值(ROC曲线下面积0.706,95％ CI 0.629～0.786;P=0.003),当截断值为2.2时敏感性和特异性分别为63.2％和72.6％.结论 NLR对急性脑出血患者转归具有一定的预测价值.     

The relationship between neutrophil to lymphocyte ratio and artery stiffness in subtypes of hypertension

Recently, neutrophil/lymphocyte ratio (NLR) has been proved to be a useful indicator of inflammation and cardiovascular risk. Brachial‐ankle pulse wave velocity is an indicator for early atherosclerotic changes. It is unknown whether NLR differs in subtypes of hypertension, and little research has been performed on the relationship between NLR and arteriosclerosis in subtypes of hypertension. The purpose of this article was to investigate their relationship. A total of 217 consecutive patients with hypertension and 132 persons without hypertension were included. All hypertension patients were divided into three groups according to office blood pressure. Brachial‐ankle pulse wave velocity was elevated in patients with isolated systolic hypertension, isolated diastolic hypertension, and systolic and diastolic hypertension compared with normotensive controls. NLR in patients with isolated systolic hypertension and systolic and diastolic hypertension were higher than in normotensive controls. Correlation analysis revealed a positive correlation between NLR and brachial‐ankle pulse wave velocity. Multivariate linear regression analysis showed that NLR was an effective indicator for brachial‐ankle pulse wave velocity.     

Utility of the neutrophil to lymphocyte ratio in predicting long-term outcomes in acute decompensated heart failure

Neutrophil-to-lymphocyte ratio (NLR) has been associated with poor outcomes in patients with acute coronary syndromes. However, its role for risk stratification in acute decompensated heart failure (ADHF) has not been well described. In this study, 1,212 consecutive patients admitted with ADHF who had total white blood cell and differential counts measured at admission were analyzed. The patients were divided into tertiles according to NLR. The association between NLR and white blood cell types with all-cause mortality was assessed using Cox regression analysis. During a median follow-up period of 26 months, a total of 284 patients (23.4%) had died, and a positive trend between death and NLR was observed; 32.8%, 23.2%, and 14.2% of deaths occurred in the higher, middle, and lower tertiles, respectively (p <0.001). After adjusting for confounding factors, multivariate analysis demonstrated that patients in the higher NLR tertile had the highest mortality (adjusted hazard ratio 2.23, 95% confidence interval (CI) 1.63 to 3.02, p <0.001), followed by those in the middle tertile (adjusted hazard ratio 1.62, 95% CI 1.16 to 2.23, p = 0.001). Furthermore, tertiles of NLR were superior in predicting long-term mortality compared with white blood cell, neutrophil, and relative lymphocyte counts. Patients in the higher NLR tertile (adjusted odds ratio 3.46, 95% CI 2.11 to 5.68, p <0.001) had a significantly higher 30-day readmission rate. In conclusion, higher NLR, an emerging marker of inflammation, is associated with an increased risk for long-term mortality in patients admitted with ADHF. NLR is a readily available inexpensive marker to aid in the risk stratification of patients with ADHF.