类风湿关节炎生物制剂治疗期间中性粒细胞淋巴细胞比率的变化及意义

发布时间：2018-03-30 00:12

  本文选题：类风湿关节炎　切入点：生物制剂　出处：《广东医学》2017年20期

【摘要】：目的探讨类风湿关节炎(RA)生物制剂治疗期间中性粒细胞淋巴细胞比率[中性粒细胞与淋巴细胞比值(NLR)]的变化及其与关节疼痛和关节功能恢复情况的关系。方法以RA患者66例为RA组,采用抗风湿药物和生物制剂益赛普治疗,3个月为1疗程,患者均治疗1个疗程以上,治疗后均随访至少3个月。另选取30例性别、年龄匹配的同期健康查体志愿者为对照组。RA组治疗前后和对照组入选次日均取静脉血2 m L进行血细胞分析检测比较两组NLR。统计RA组治疗前、治疗后和随访3个月的关节疼痛视觉模拟评分(VAS)和关节功能分级。分析RA生物制剂治疗期间NLR评估与其治疗后3个月关节疼痛和关节功能恢复情况的关系及其对关节疼痛和关节功能恢复不良的预测价值。结果与对照组比较,RA组治疗前的NLR升高(P0.05)。与治疗前比较,RA组治疗后的NLR降低(P0.05)。与RA组随访3个月VAS≥4分患者比较,其VAS4分患者治疗前后的NLR降低(P0.05)。与RA组随访3个月关节功能为Ⅱ级和Ⅲ级患者比较,其随访3个月关节功能为Ⅰ级患者治疗前后的NLR降低(P0.05)。Spearman无条件相关分析结果显示,RA生物制剂治疗前后的NLR与访3个月的VAS评分及关节功能分级均呈正相关。ROC曲线分析结果显示,RA生物制剂治疗前后的NLR评估其随访3个月的VAS评分及关节功能分级的价值良好,其中以治疗后的NLR评估其随访3个月的VAS评分及关节功能分级的价值较好。结论 RA生物制剂治疗可降低患者NLR,其NLR与治疗后关节疼痛及关节功能恢复情况均相关,且对其关节疼痛和关节功能恢复情况预测价值良好,NLR可能作为RA生物制剂治疗患者关节疼痛和关节功能恢复情况评估的参考指标。
[Abstract]:Objective to investigate the changes of neutrophil lymphocyte ratio (neutrophil to lymphocyte ratio) during the treatment of rheumatoid arthritis (RA) and its relationship with joint pain and joint function recovery. 66 patients with RA were in RA group. The patients were treated with antirheumatic drugs and biologic agents Isop for a course of 3 months or more. All patients were followed up for at least 3 months after treatment. 30 cases of sex were selected. The age matched healthy volunteers of the same period were the control group. Before and after treatment and the control group, the venous blood was taken from 2 mL of vein blood before and after treatment, and the blood cell analysis was made between the two groups. Before and after treatment, NLRs of the two groups were analyzed and compared. Visual analogue score of joint pain (VAS) and joint function grading were evaluated after treatment and 3 months follow-up. The relationship between NLR evaluation during RA biologic therapy and joint pain and recovery of joint function at 3 months after treatment was analyzed. Results compared with the control group, the NLR of RA group increased before treatment, and the NLR of RA group decreased after treatment compared with that before treatment. Compared with the patients with VAS 鈮，

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