中性粒细胞/淋巴细胞比值等4项指标对溃疡性结肠炎内镜活动度的判断价值

目的探讨中性粒细胞/淋巴细胞比值(neutrophils-lymphocytes ratio,NLR)、单核细胞/淋巴细胞比值(monocyte-lymphocytes ratio,MLR)、C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)判断溃疡性结肠炎(ulcerative colitis,UC)内镜活动度的价值。方法收集广西医科大学第一附属医院2012年8月至2018年8月住院的112例UC患者,87例肠易激综合征(irritable bowel syndrome,IBS)患者数据,依据改良Mayo评分及蒙特利尔分型分组,并采用改良Mayo评分评估UC患者内镜活动度,探究NLR、MLR、CRP、ESR对UC内镜活动度的判断价值。结果(1)UC组NLR、MLR、CRP、ESR均高于IBS组;(2)UC活动期组NLR、MLR、CRP、ESR均高于愈合期组,NLR、MLR、CRP、ESR水平与内镜下改良Mayo评分呈正相关,除ESR外,NLR、MLR、CRP水平在不同病变范围组中无差异;(3)根据ROC曲线分析,四者中NLR判断UC内镜活动度的效能最佳,其曲线下面积(AUC)为0.795,当截断值为1.56时,敏感度为0.844,特异度为0.687;NLR、MLR、CRP、ESR联合较各指标独立判断效能更佳,其AUC为0.850,当截断值为0.88时,敏感度为0.667,特异度为0.937。结论NLR、MLR、CRP、ESR均可判断UC内镜活动度,可用于UC内镜活动度的监测,其中NLR判断效能最佳,四者联合效能更佳。

Value of NLR,MLR,CRP and ESR in judging the endoscopic activity of ulcerative colitis

Objective To explore the value of neutrophil/lymphocyte ratio(NLR),monocyte/lymphocytes ratio(MLR),Creactive protein(CRP),erythrocyte sedimentation rate(ESR)in judging the endoscopic activity of ulcerative colitis.Method Data were collected from 112 UC patients and 87 patients with irritable bowel syndrome(IBS)who were hospitalized in the First Affiliated Hospital of Guangxi Medical University from August 2012 to August 2018.The included patients were grouping basing on the modified Mayo score and Montreal classification.UC patients’endoscopy disease activity was judged by modified Mayo score.And researchers explored the value of NLR,MLR,CRP,ESR in judging the disease activity degree of UC endoscope.Results Frist,NLR,MLR,CRP,ESR in UC group were higher than that in IBS group.Second,The NLR,MLR,CRP and ESR in active period of the UC group were higher than that in healing period,and the levels of NLR,MLR,CRP and ESR were positively related to the modified Mayoscore under the endoscope.There was no statistically significant difference on NLR,MLR and CRP in different lesions.Third,the ROC curve of NLR,MLR,CRP,and ESR separately evaluating the UC endoscope activity separately suggested that the NLR had the best efficiency in evaluating the UC endoscope activity when separately exploring vaule of NLR,MLR,CRP and ESR(AUC 0.795,sensitivity 84.4%,specificity 68.7%).And the combined judgment of the four index was better than any singleindex.(AUC 0.850,sensitivity66.7%,specificity 93.7%).The four combined detection was better than the index alone in judging the UC endoscopic activity efficiency.Conclusion NLR,MLR,CRP and ESR reflect the UC endoscopy activety.Among them,NLR has the best performance.And the combined judgment of the four indexis better than any single index.