【摘要】 目的探讨中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)对甲状腺相关性眼病(TAO)的预测价值。方法回顾性收集2016年1月至2020年8月就诊于河南省人民医院眼科的196例TAO患者(TAO组)的临床资料。按临床活动度评分(CAS)将TAO组患者分为非活动期组(CAS<3分,101例)和活动期组(CAS≥3分,95例)。另同期选择150名河南省人民医院健康管理中心体检者作为对照组。收集研究对象的临床资料。使用logistic回归分析TAO活动性分期的影响因素。使用受试者工作特征(ROC)曲线评估NLR、PLR是否可以作为TAO疾病活动性的客观预测指标。结果 TAO组白细胞计数、中性粒细胞计数、NLR、PLR均高于对照组,TAO组淋巴细胞计数低于对照组(P<0.05)。与非活动期组比较,活动期组突眼度较大,眼肌受累条数较多,白细胞计数、中性粒细胞计数、血小板计数、NLR、PLR均较高(P<0.05)。突眼度(OR=1.226,95%CI:1.144～1.315,P<0.001)、眼肌受累条数(OR=1.180,95%CI:1.039～1.341,P=0.011)、白细胞计数(OR=2.260,95%CI:1.285～3.975,P=0.005)、NLR(OR=2.258,95%CI:1.109～4.599,P=0.025)、PLR(OR=1.012,95%CI:1.001～1.023,P=0.028)是TAO活动性分期的独立危险因素。NLR预测TAO活动性分期的曲线下面积为0.771(95%CI:0.722～0.820,P<0.001)。PLR预测TAO活动性分期的曲线下面积为0.636(95%CI:0.578～0.694,P<0.001)。结论 TAO患者外周血NLR、PLR升高,其升高程度与疾病活动性有关。NLR、PLR可以被作为预测TAO活动性分期的重要指标。更多还原

【Abstract】 Objective To explore the predictive value of neutrophil to lymphocyte ratio(NLR) and platelet to lymphocyte ratio(PLR) in thyroid associated ophthalmopathy(TAO).Methods The clinical data of 196 patients with TAO(TAO group) who visited the Department of Ophthalmology in Henan People’s Hospital from January 2016 to August 2020 were retrospectively analyzed. According to clinical activity score(CAS), the patients in TAO group were divided into inactive group(CAS was less than 3 points) and active group(CAS was 3 points or more), and there were 101 cases in inactive group and 95 cases in active group. In the same period, 150 healthy people in the Health Management Center of Henan Provincial People’s Hospital were selected as control group. The clinical data of the subjects were collected. Logistic regression was used to analyze the influencing factors of TAO activity staging. Receiver operating characteristic(ROC) curve was used to evaluate whether NLR and PLR could be used as objective predictors of TAO’ s disease activity.Results The white blood cell count, neutrophil count, NLR and PLR in TAO group were higher than those in control group, while the lymphocyte count in TAO group was lower than that in control group(P<0.05). Compared with inactive group, active group had greater exophthalmos, more involved ocular muscles, and the white blood cell count, neutrophil count, platelet count, NLR and PLR were all higher(P<0.05). Exophthalmos(OR=1.226, 95% CI: 1.144 to 1.315, P<0.001), the number of ocular muscle involvement(OR=1.180, 95% CI: 1.039 to 1.341, P=0.011), white blood cell count(OR=2.260, 95% CI: 1.285 to 3.975, P=0.005), NLR(OR=2.258, 95% CI: 1.109 to 4.599, P=0.025), PLR(OR=1.012, 95% CI: 1.001 to 1.023, P=0.028) were independent risk factors for TAO active staging. The area under the curve of NLR as an indicator for predicting TAO activity staging was 0.771(95% CI: 0.722 to 0.820, P<0.001). The area under the curve of PLR as an indicator of TAO activity staging was 0.636(95% CI: 0.578 to 0.694, P<0.001).Conclusion The levels of NLR and PLR in peripheral blood of patients with TAO are increased, and the degrees of increase are related to the activity of the disease. NLR and PLR could be used as important indexes to predict the active stage of TAO.更多还原