APACHEⅡ评分、Ranson评分及EPIC评分对急性胰腺炎预后评价的比较——附198例报告

目的：比较急性生理学及慢性健康状况Ⅱ（acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ）评分、Ranson评分及腹部CT胰腺外炎症（extrapancreatic inflammation on abdominal computed tomography,EPIC）评分预测急性胰腺炎（acute pancreatitis,AP）预后的价值。方法：临床资料完整的AP患者198例,其中确诊为重症急性胰腺炎（severe acute pancreatitis,SAP）60例,轻症急性胰腺炎（mild acute pancreatitis,MAP）138例,采用受试者工作特性曲线分析APACHE Ⅱ评分、Ranson评分、EPIC评分预测AP的病情严重程度、并发症的价值。结果：198例患者中,SAP和MAP患者APACHE Ⅱ评分、Ranson评分、EPIC评分分值比较差异有统计学意义（均为P〈0．01）。EPIC评分标准判断SAP的敏感度、特异度最高,曲线下面积最大,且其预测局部并发症的曲线下面积最大,而APACHE Ⅱ评分预测全身并发症的曲线下面积最大。结论：对入院24h内的AP患者,EPIC评分结合APACHE Ⅱ评分能有效预测其预后,而Ranson评分不具优势。     

膀胱尿路上皮细胞癌患者外周血NLR，PLR，MLR 和RDW 水平表达及在临床分期评估中的价值

目的 观察膀胱尿路上皮细胞癌外周血中性粒细胞计数/ 淋巴细胞计数比率（NLR）,血小板计数/ 淋巴细胞计数比率（PLR）,单核细胞计数/ 淋巴细胞计数比率（MLR）和红细胞体积分布宽度（RDW）表达情况,并分析其在临床分期评估中的价值。方法 回顾性分析118 例膀胱尿路上皮细胞癌病例资料,所有病例均于治疗前清晨空腹采血行NLR,PLR,MLR 和RDW 水平表达检测,观察不同临床分期患者外周血NLR,PLR,MLR 和RDW 水平表达差异及相关性,采用ROC 曲线法分析外周血NLR,PLR,MLR 和RDW 在膀胱尿路上皮细胞癌临床分期评估中的效能。结果 患者外周血NLR,PLR 和RDW表达水平随临床分期的提升而提升,外周血MLR表达水平下降,且不同临床分期(TⅠ期、TⅡ期、TⅢ期和TⅣ期) 病例的外周血NLR,PLR,MLR 和RDW 表达比较差异具有统计学意义(F=31.152~56.182,均P ＜ 0.05)。Spearman 秩相关性分析显示:外周血NLR(r = 0.813,P=0.016),PLR(r= 0.881,P=0.013) 和RDW(r = 0.857,P=0.014) 与临床分期呈正相关(P ＜ 0.05);外周血NLR(r = - 0.583,P=0.014) 与临床分期呈负相关(P ＜ 0.05)。ROC曲线数据显示:外周血NLR,PLR,MLR 和RDW 表达水平鉴别临床分期的曲线位于参考线之上,且外周血NLR,PLR,MLR 和RDW 在鉴别TⅠ期与TⅡ期、TⅡ期与TⅢ期、TⅢ期与TⅣ期的准确度、敏感度和特异度均高于80%。结论 外周血NLR,PLR,MLR 和RDW 与膀胱尿路上皮细胞癌临床分期具有相关性,其在鉴别膀胱尿路上皮细胞癌临床分期中具有一定的临床价值。     

血液相关标志物与急性胰腺炎病情严重程度的相关性研究

目的探讨中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、红细胞分布宽度(red cell distribution width,RDW)、C-反应蛋白(C-reactive protein,CRP)与急性胰腺炎(acute pancreatitis,AP)病情严重程度的相关性。方法选取2017年1月至2019年10月解放军总医院第六医学中心收治的AP患者214例,将其设为病例组。另选取同期健康体检者30例为对照组。根据病情严重程度,将病例组分为轻度组(mild acute pancreatitis,MAP)149例,中重度组(moderately severe acute pancreatitis,MSAP)35例、重度组(severe acute pancreatitis,SAP)30例。比较病例组与对照组及病例组三个亚组间入院24h NLR、RDW、CRP的差异;分析病例组NLR、RDW、CRP与急性生理与慢性健康评分(acute physiology and chronic health evaluation,APACHEⅡ评分)的相关性。应用ROC曲线评估NLR、RDW、CRP单独及联合检测对SAP的预测价值。结果病例组NLR、RDW、CRP明显高于对照组(P<0.05);SAP组的NLR、RDW、CRP显著高于MSAP组、且MSAP组显著高于MAP组,差异有显著性(P<0.05);病例组NLR、RDW、CRP与APACHEⅡ评分呈正相关(r分别为0.683、0.594、0.702,P<0.05)。ROC曲线分析提示,NLR、RDW、CRP预测SAP的曲线下面积分别为0.846、0.807和0.872;敏感性分别为87.5%、81.3%和82.5%;特异性分别为79.5%、76.2%和86.1%。NLR、RDW、CRP三者联合检测预测SAP的AUC值为0.916,敏感性为91.8%,特异性为86.2%。结论AP患者发病早期NLR、RDW、CRP明显升高,与病情严重程度相关,均是预测SAP的理想指标。三者联合检测在预测SAP方面诊断价值更高。     

中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值及超敏C反应蛋白预测急性缺血性卒中患者阿替普酶溶栓治疗后卒中相关性肺炎的临床价值

目的 探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)及超敏C反应蛋白(hs-CRP)预测急性缺血性卒中(AIS)患者阿替普酶溶栓治疗后卒中相关性肺炎(SAP)的临床价值。方法 接受阿替普酶溶栓治疗的120例AIS患者,根据治疗后是否发生SAP分为肺炎组(n=25)和非肺炎组(n=95),选取同期体检健康者50例为对照组,比较3组NLR、PLR及hs-CRP水平,分析NLR、PLR、hs-CRP单项检测及联合检测对SAP的预测价值。对SAP患者进行随访,分析影响SAP患者不良预后的危险因素。结果 120例AIS患者发生SAP 25例(20.83%);肺炎组NLR、PLR、hs-CRP水平较其他两组显著升高(P<0.05);NLR、PLR、血清hs-CRP单项预测SAP的ROC曲线下面积分别为0.836、0.867、0.879,敏感度分别为76.00%、76.00%、80.0%,特异度分别为87.40%、90.05%、76.80%,上述三项联合预测SAP的ROC曲线下面积、敏感度、特异度分别为0.889、82.00%、97.89%,均高于三者单独应用(P<...     

急性胰腺炎床边指数评分对疾病程度及预后的预测价值

目的与急性胰腺炎（acute pancreatitis,AP）传统评分系统进行比较,探讨急性胰腺炎严重程度床边指数（bedside index for severity in acute pancreatitis,BISAP）评分对疾病程度及预后的预测价值。方法 202例AP患者分别行BISAP、急性生理和慢性健康状况评分（Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ）及Ranson评分,比较分析3种评分系统预测AP严重程度、局部并发症、器官功能衰竭的价值。结果 202例AP患者,轻症急性胰腺炎（mild acute pancreatitis,MAP）103例,重症急性胰腺炎（severe acute pancreatitis,SAP）99例;SAP患者发生局部并发症62例,器官功能衰竭60例,23例二类并发症均存在;BISAP评分预测SAP的AUC为0.881（95%CI：0.836-0.927）,最佳cutoff值为2,其预测SAP敏感性、特异性、阳性预测值及阴性预测值分别为88.89%、71.84%、75.21%和87.06%;预测SAP患者局部并发症的AUC为0.715（95%CI：0.644-0.785）,最佳cutoff值为3,预测SAP局部并发症的敏感性、特异性、阳性预测值及阴性预测值分别为77.42%、75.00%、57.83%和88.24%;预测SAP患者器官功能衰竭的AUC为0.884（95%CI：0.837-0.931）,最佳cutoff值为3,预测SAP患者器官功能衰竭的敏感性、特异性、阳性预测值及阴性预测值分别为76.67%、85.21%、68.66%和89.63%。BISAP评分预测AP严重程度、局部并发症、器官功能衰竭的能力与APACHEⅡ和Ranson评分比较差异无统计学意义（P〉0.05）。结论 BISAP评分对AP严重程度及预后预测价值与传统评分相同,但构成简单,主观偏倚小,可动态监测变化。     

APACHEⅡ,Ranson与BalthazarCT评分在重症急性胰腺炎患者预后评估中的应用价值

目的探讨APACHEⅡ、Ranson、Balthazar CT三种评分系统在重症急性胰腺炎（severe acute pancreatitis,SAP）患者预后评估中的价值。方法以2007年1月至2008年12月入住四川大学华西医院加强医疗科（ICU）资料完整的134例SAP患者为研究对象,回顾性分析APACHEⅡ评分、Ranson评分及Balthazar CT分级与SAP病死率的关系。结果APACHEⅡ、Ranson、Balthazar CT三种评分系统中高分组与低分组在病死率方面差异有统计学意义。APACHEⅡ、Ranson与Balthazar CT综合分型：APACHEⅡ、Ranson高分组中CT分级病死率差异有统计学意义。结论APACHEⅡ、Ranson及Balthazar CT评分系统综合分型结果对SAP患者预后评估具有重要参考价值,三种评分系统联合使用对诊治及预后评估更具有临床指导意义。     

中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值对溃疡性结肠炎的诊断价值

目的探讨中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)在溃疡性结肠炎(UC)患者外周血中的水平,评估两者对UC的诊断效能。方法收集87例UC患者纳入UC组,收集65例肠易激综合征(IBS)患者纳入对照组。分析患者临床资料,比较两组NLR和PLR水平差异;采用Pearson相关分析NLR、PLR与临床常用指标白细胞计数(WBC)、血小板计数(PLT)、C反应蛋白(CRP)、红细胞沉降率(ESR)的相关性;采用受试者工作特征(ROC)曲线计算NLR和PLR最佳临界值及曲线下面积(AUC),并与常用炎性指标进行比较。结果UC组患者外周血NLR和PLR均明显高于对照组(P<0.05)。相关性分析发现,NLR、PLR均与WBC、CRP和ESR呈正相关(P<0.05)。NLR用于诊断UC的最佳临界值为2.64,灵敏度和特异度分别为81.9%和62.6%,AUC为0.758,PLR用于诊断UC的最佳临界值为163.40,灵敏度和特异度分别为75.0%和60.6%,AUC为0.759,两者均优于WBC(AUC:0.687)和PLT(AUC:0.745),稍逊于ESR(AUC:0.783)和CRP(AUC:0.830)。NLR联合CRP、PLR联合CRP对UC的诊断价值均优于CRP单独检测。结论NLR和PLR在UC患者外周血中的水平升高。NLR、PLR诊断UC的效能优于常用指标WBC和PLT,其与CRP联合应用可提高UC的诊断效能。     

感染性荨麻疹腹痛与中性粒细胞/淋巴细胞比值及血小板/淋巴细胞比值的关系

目的分析急性荨麻疹腹痛患者在合并感染及无感染的情况下,超敏C-反应蛋白(hs-CRP)水平、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)的变化与急性荨麻疹腹痛的关系。方法选取该院急性荨麻疹腹痛患者100例,按患者有无感染,分为感染性荨麻疹腹痛组(感染组)和非感染性荨麻疹腹痛组(非感染组),每组50例。另随机选取同期于该院就诊的其他原因导致的急性荨麻疹不伴腹痛患者50例作为对照组。测定3组患者的hs-CRP、NLR、PLR水平,利用受试者工作特征曲线(ROC曲线)进行灵敏度与特异度分析。结果感染组患者hs-CRP水平、NLR、PLR高于非感染组和对照组,差异均有统计学意义(P0.05),而非感染组和对照组各指标比较差异无统计学意义(P0.05)。hs-CRP用于感染性荨麻疹腹痛诊断的ROC曲线下面积(AUC)为0.997,最佳诊断值为13.56mg/L,灵敏度为96%,特异度为80%。NLR对感染性荨麻疹腹痛ROC曲线下AUC为0.843,最佳诊断值为17.67,灵敏度为70%,特异度为88%。PLR对感染性荨麻疹腹痛ROC曲线下AUC为0.974,最佳诊断值为224.85,灵敏度为94%,特异度为92%。结论 hsCRP、NLR和PLR水平对感染性荨麻疹腹痛的诊断均具有较高的灵敏度和特异度,值得进行临床推广使用。     

胰腺炎活动评分系统对急性胰腺炎活动性的预测价值

目的评估胰腺炎活动评分系统(pancreatitis activity scoring system, PASS)预测急性胰腺炎(acute pancreatitis, AP)活动性的价值, 以期降低AP患者的死亡风险、改善预后。方法前瞻性收集2020年1月至2021年6月安徽医科大学第一附属医院急诊科AP患者的临床资料。根据美国2012年Atlanta标准分为轻症急性胰腺炎(mild acute pancreatitis, MAP)组、中度重症急性胰腺炎(moderately severe acute pancreatitis, MSAP)与重症急性胰腺炎(severe acute pancreatitis, SAP)组, 比较两组患者在基本信息、Ranson评分、床旁急性胰腺炎严重度指数(bedside index for severity in acute pancreatitis, BISAP)评分、急性生理与慢性健康(acute physiology and chronic health evaluation, APACHE)Ⅱ评分和PASS之间的差异。并使用受试者操作特性曲...     

外周血中性粒细胞/淋巴细胞比率、血小板/淋巴细胞比率与干燥综合征疾病活动的相关性分析

目的探讨外周血中性粒细胞/淋巴细胞比率(NLR)、血小板/淋巴细胞比率(PLR)在干燥综合征(SS)患者病情评估中的价值。方法收集就诊于我院的62例干燥综合征患者及51例健康体检者临床资料,计算其NLR、PLR数值,比较两组NLR、PLR差异。分析SS患者NLR、PLR与各临床指标的相关性。以ESSDAI评分4分为活动,绘制ROC曲线评价NLR、PLR对疾病活动的判断作用。结果 SS患者NLR、PLR水平高于健康对照者。两者均与球蛋白、IgG、IgA、RF正相关,与总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)负相关,且两者间亦呈正相关。多元线性回归分析显示NLR与PLR、TC、LDL-C相关,而PLR则与NLR、球蛋白、IgG、TC相关。ROC曲线分析显示PLR对评估SS病情活动性的特异度较高。结论 NLR、PLR与SS病情相关,对于SS疾病活动评估有一定价值。     

Correlation between neutrophil/lymphocyte ratio and Ranson score in acute pancreatitis

Background

Acute pancreatitis (AP) is characterized by inflammation of the pancreas, elevated pancreatic enzymes, and abdominal pain. The neutrophil to lymphocyte ratio (NLR) is used as a marker of inflammation. In this retrospective study, we aimed to investigate novel early prognostic predictors of AP, such as NLR and its correlation with the Ranson score.

Methods

A total 435 patients (Male: 152; 34.9%, Age: 63.53 ± 17.22 years) were included in the study. Data were collected by two clinicians scanning the registered hospital records.

Results

Classification of the patients according to the aetiologies revealed gallstone(s) 58.6% (n = 255), hyperlipidaemia 2.2% (n = 9), viruses 0.7% (n = 3), malignancies 0.5% (n = 2), and alcohol 0.2% (n = 1). No reason was discovered in 37.9% (n = 165) of patients. Age, duration in the intensive care unit, serum aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma‐glutamyl transferase (GGT), total bilirubin, direct bilirubin, lactate dehydrogenase (LDH), white blood cell (WBC) count, neutrophil count, lymphocyte count, and the NLR were greater in the group with a Ranson score ≥3 than the group with a Ranson score <3.

Discussion

Quick diagnosis is essential in AP. Current scoring systems for AP diagnosis are complicated, whereas NLP is a simple, practical, and effective marker.

     

血常规相关指标在急性胰腺炎分期和病情评估中的作用分析

目的探讨血常规相关指标在急性胰腺炎(AP)分期和病情评估中的作用及价值。方法选择2018年10月至2020年3月该院收治的AP患者115例,其中重度急性胰腺炎(SAP)55例(SAP组)、轻度急性胰腺炎(MAP)60例(MAP组),并随机选取同期在该院体检的健康体检者40例(对照组)。从55例SAP患者中筛选出35例治愈出院患者,标注入院第1、3、7天为SAP1、SAP3、SAP7。收集所有研究对象血常规相关指标,并通过绘制受试者工作特征(ROC)曲线评估各指标鉴别MAP与SAP的效能。结果 MAP组和SAP组分别与对照组相比有较多数值有差异;SAP组与MAP组比较,红细胞分布宽度(RDW-S)、中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)更高,淋巴细胞(LY)水平更低,差异均有统计学意义(P<0.05)。通过绘制ROC曲线可知,RDW-S、NLR和PLR对SAP和MAP鉴别的曲线下面积(AUC)分别为0.631、0.668和0.616,此三项联合鉴别诊断的AUC为0.714;预后良好的SAP患者在入院第1、3、7天的血常规指标中NLR、PLR、血小板分布宽度(PDW)呈逐渐下降的趋势,且第1天与第7天的水平差异有统计学意义(P<0.05)。LY在第7天水平明显升高,分别与第1天和第3天比较,差异有统计学意义(P<0.05)。结论 (1)RDW-S、NLR和PLR可以作为鉴别MAP与SAP的指标,且三项联合鉴别诊断的AUC优于单项诊断;(2)在SAP病情恢复期间,NLR、PLR、PDW、LY可以作为判断病情的监测指标。     

NLR、PLR在高血脂症性急性胰腺炎诊断及病情评估中的价值

目的探究中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)在高血脂症性急性胰腺炎(HLAP)诊断及病情评估中的价值。方法选取本院132例HLAP患者作为观察组,另选取同期66例胆源性、酒精性急性胰腺炎非HLAP患者作为对照组,66例健康体检者作为健康组,比较3组NLR、PLR、血脂指标[总胆固醇(TC)、三酰甘油(TG)]、炎性因子[C反应蛋白(CRP)、降钙素原(PCT)],分析NLR、PLR与血脂指标、炎性因子相关性,采用受试者工作特征(ROC)曲线评价NLR、PLR诊断价值,对比观察组不同病情程度患者NLR、PLR水平,分析NLR、PLR与HLAP病情程度的关系。结果观察组NLR、PLR、TC、TG、CRP、PCT高于对照组、健康组,对照组高于健康组,差异有统计学意义(P<0.05);Pearson相关性分析,NLR、PLR与TC、TG、CRP、PCT呈正相关(P<0.05);ROC曲线分析,NLR、PLR联合诊断AP的AUC为0.901,95%CI为0.858~0.934,敏感度为80.30%,特异度为92.42%,两者联合诊断HLAP的AUC为0.846,95%CI为0.788~0.893,敏感度为71.21%,特异度为83.33%,均优于两者单独诊断,差异有统计学意义(P<0.05);观察组重度患者NLR、PLR高于中度患者、轻度患者,中度患者高于轻度患者,差异有统计学意义(P<0.05);Spearman相关性分析,NLR、PLR与HLAP病情程度呈正相关(P<0.05)。结论 NLR、PLR联合检测在HLAP诊断与病情评估中具有较高临床价值。     

中性粒细胞/淋巴细胞比值在评估早期脊髓损伤严重程度中的应用研究

目的:探讨脊髓损伤(SCI)患者入院首次外周血中性粒细胞与淋巴细胞比值(NLR)对其损伤严重程度的早期评估作用。方法:回顾性分析2010年6月至2021年1月由陆军军医大学附属西南医院急诊收入并转入康复科住院治疗的SCI患者62例,根据伤后ASIA损伤分级将纳入患者分为完全性运动损伤组(ASIA损伤分级A级或B级)35例,不完全性运动损伤组(ASIA损伤分级C级、D级)27例。收集2组患者的临床资料及实验室检验资料,根据入院时中性粒细胞计数、淋巴细胞计数计算NLR,应用单因素分析比较2组间资料差异,应用多因素Logistic回归分析完全性运动损伤的可能危险因素,利用受试者工作特征(ROC)曲线下面积评估各指标的评估能力。结果:完全性运动损伤组患者的入院后首次NLR值水平显著高于不完全性运动损伤组(P<0.05),淋巴细胞计数水平明显低于不完全性运动损伤组(P<0.01)。多因素Logistic回归分析显示,调整混杂因素后,淋巴细胞计数水平升高是脊髓损伤后完全性运动损伤的独立保护因素(OR=0.211,95%CI:0.051~0.878,P<0.05)。NLR值的曲线下面积为0.726(95%CI:0.598~0.854,P<0.05),当截断值为9.711时,有最大约登指数0.398,其敏感度为65.71%,特异度为74.07%;淋巴细胞计数的曲线下面积为0.740(95%CI:0.610~0.870,P<0.05),当截断值为1.220时,有最大约登指数0.461,其敏感度为94.29%,特异度为51.85%;二者联合的曲线下面积为0.751(95%CI:0.625~0.878,P<0.05)。结论:入院后首次NLR值作为简单、便宜、容易获得的检验指标,可能对早期SCI严重程度有一定评估价值。     

慢性阻塞性肺疾病患者血清中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、降钙素原水平与急性加重风险的相关性研究

目的探讨慢性阻塞性肺疾病(COPD)患者血清中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、降钙素原(PCT)表达水平与急性加重风险的相关性。方法选取2018年1月至2020年1月我院收治的COPD患者252例,按照病情严重程度分为151例COPD急性加重期(AECOPD)组与101例稳定期(SCOPD)组,并选取同时期健康体检者150例为对照组。检测三组血清NLR、PLR、PCT水平,分析血清NLR、PLR、PCT水平预测COPD急性加重风险的价值及相关性。结果 AECOPD组与SCOPD组血清NLR、PLR、PCT水平均高于对照组,且AECOPD组高于SCOPD组(P<0.05); ROC曲线分析显示,NLR敏感度与特异度分别为84.8%、84.2%,PLR敏感度与特异度分别为81.5%、82.2%,PCT敏感度与特异度分别为91.4%、91.1%;Ⅳ级患者血清NLR、PLR、PCT水平高于Ⅲ级、Ⅱ级和Ⅰ级患者(P<0.05); COPD患者血清NLR、PLR水平与PCT呈正相关(P<0.05)。结论 COPD患者血清NLR、PLR、PCT水平...     

The value of the neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as complementary diagnostic tools in the diagnosis of rheumatoid arthritis: A multicenter retrospective study

BackgroundThe neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) have drawn attention in recent years as novel non‐specific inflammatory markers; however, only a few studies have been conducted to investigate their value in RA.ObjectiveTo investigate the value of the neutrophil‐to‐lymphocyte ratio (NLR) and the platelet‐to‐lymphocyte ratio (PLR) as complementary diagnostic tools in rheumatoid arthritis (RA).MethodThis study included 1009 patients with RA, 170 patients with other rheumatic diseases, and 245 healthy individuals from four medical centers. The patients'' general data, including complete blood count, C‐reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF), were retrospectively analyzed, and the NLR and PLR were calculated. Potential effective indicators were screened by logistic regression analysis, and a receiver operating characteristic (ROC) curve was plotted to evaluate their diagnostic value for RA.Results(a) The NLR and PLR were significantly higher in the RA group than in the non‐RA group and the control group (P < .05). (b) Spearman''s Rho showed that the NLR was positively correlated with the PLR (r = .584, P < .05), RF (r = .167, P < .01), and CRP (r = .280, P < .01) but was not significantly correlated with ESR (r = .100, P > .05). The PLR was positively correlated with RF (r = .139, P < .01), CRP (r = .297, P < .01), and ESR (r = .262, P < .05). (c) Logistic analysis showed that RF, CRP, ESR, and the NLR had diagnostic value for RA. (d) For the NLR, the area under the curve (AUC) of the ROC curve was 0.831; at the cutoff value of 2.13, the diagnostic sensitivity, specificity, accuracy, and Youden index were 76.7%, 75.9%, 76.4%, and 0.5424, respectively.ConclusionThe NLR was less effective than CRP and RF but was superior to ESR in the diagnosis of RA. The NLR can thus be used as a complementary diagnostic indicator in the diagnosis of RA.     

Predictive value of NLR and PLR in missed miscarriage

BackgroundThe aim of the study was to investigate the predictive value of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in missed miscarriage.MethodsIn this retrospective cohort study, a total of 400 women (involving 200 with missed early miscarriage and 200 with normal pregnancy but terminate by artificial abortion) were included. General clinical data and complete blood count (CBC) such as white blood cells (WBC), red blood cells (RBC), platelet (PLT), red blood cell distribution width‐standard deviation (RDW‐SD), platelet distribution width (PDW), mean platelet volume (MPV), neutrophil count, and lymphocyte count were collected, and the NLR and PLR were calculated for both groups. Receiver operating characteristic curve (ROC) was used to calculate the predictive value.ResultsThere was no significant difference in the WBC, RBC, PLT, RDW‐SD, PDW, neutrophil, lymphocyte, NLR, and PLR between the two groups (p > 0.05).But MPV was lower in the missed early miscarriage group than in the control group (p < 0.05), and the area under the working curve (AUC) of ROC was 0.58, specificity and sensitivity was 69% and 47%, respectively.ConclusionNLR and PLR were not the suitable indictor for missed miscarriage, but MPV should be a concern in the first trimester.     

Diagnostic performances of neutrophil to lymphocyte ratio and lymphocyte to monocyte ratio in acute ischemic stroke caused by cervicocranial arterial dissection

BackgroundInflammation plays an important role in the initiation and progression of cervicocranial arterial dissection (CCAD). New inflammatory indices derived from full cell blood count may be associated with increased risk of acute ischemic stroke (AIS) caused by CCAD. The goal of this study is to evaluate the diagnostic performances of neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ratio (LMR) in CCAD.MethodWe retrospectively analyzed 52 patients with AIS caused by CCAD from emergency room (group I), 51 patients with CCAD from emergency room or clinic(group II) and 52 controls (group III), age and sex matched. Data were collected on the admission including NLR and LMR.ResultsNeutrophil to lymphocyte ratio and LMR have significant differences among three groups, especially in group I vs both groups II and III (P < .001). There was a negative correlation between admission NLR and LMR. Low LMR level and high NLR level may be associated with severity of AIS caused by CCAD and significantly predict AIS in CCAD. The area under the curve of NLR and LMR were 0.77 and 0.71, respectively, on receiver operating characteristic curve analysis. The optimal cutoff values of NLR and LMR that best discriminated AIS were 2.35 (81% sensitivity and 63% specificity) and 3.67 (64% sensitivity and 77% specificity).ConclusionsNeutrophil to lymphocyte ratio neutrophil to lymphocyte ratio and LMR may contribute to the diagnostic evaluation and prompt immediate therapy in patients with CCAD.