南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (10): 1651-1656.doi: 10.12122/j.issn.1673-4254.2023.10.01

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中性粒细胞/淋巴细胞、血小板/淋巴细胞比值是评价托法替尼治疗后类风湿关节炎活动性的有效指标

唐 娟，陈 娟，林国新，张 浩，桂 明，李楠楠，谷依红，罗林娟，孙 剑   

  1. 中南大学湘雅三医院肾病风湿免疫科，麻醉科，湖南 长沙 410013；余姚市人民医院肾内科，浙江 余姚 315499
  • 出版日期:2023-10-20 发布日期:2023-11-02

Neutrophil-lymphocyte and platelet-lymphocyte ratios for assessing disease activity in patients with rheumatoid arthritis receiving tofacitinib treatment

TANG Juan, CHEN Juan, LIN Guoxin, ZHANG Hao, GUI Ming, LI Nannan, GU Yihong, LUO Linjuan, SUN Jian   

  1. Department of Nephrology and Rheumatology, Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha 410013, China; Department of Nephrology, Yuyao People's Hospital, Yuyao 315499, China
  • Online:2023-10-20 Published:2023-11-02

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摘要： 目的 探讨接受托法替尼治疗的类风湿关节炎（RA）患者新兴炎症标志物中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）与炎症因子IL-6、疾病活动性的关系。方法 选取2019~2021年在湘雅第三医院确诊的RA患者98例，健康对照100例。在托法替尼治疗前1个月和治疗后6个月采集血样，测定红细胞沉降率（ESR）、C反应蛋白（CRP）、白介素6（IL-6）及其他血液参数，评估托法替尼治疗前后RA患者的PLR和NLR，分析二者与RA疾病活动性指标的相关性。结果 RA患者PLR、NLR较健康对照组明显升高。在托法替尼治疗之前与之后，PLR、NLR与超敏C反应蛋白（hs-CRP）、ESR、IL-6、DAS28-ESR值及RA生物标志物抗环瓜氨酸肽（CCP）和类风湿因子（RF）水平均呈正相关关系。与治疗前相比，RA患者接受托法替尼治疗6个月后 hs-CRP、ESR、IL-6、CCP、RF和DAS28-ESR水平明显降低。结论 NLR和PLR是评价托法替尼治疗后RA疾病活动性的有效指标。

关键词: 中性粒细胞与淋巴细胞比值；血小板与淋巴细胞比值；类风湿关节炎；托法替尼

Abstract: Objective To evaluate the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for assessing disease activity in patients with rheumatoid arthritis (RA) treated with tofacitinib. Methods This retrospective study was conducted among 98 RA patients in active stage treated with tofacitinib in Third Xiangya Hospital and 100 healthy control subjects from the Health Management Center of the hospital from 2019 to 2021. We collected blood samples from all the participants for measurement of erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and other blood parameters 1 month before and 6 months after tofacitinib treatment. We further evaluated PLR and NLR before and after tofacitinib treatment in the RA patients, and analyzed their correlations with RA disease activity. Results PLR and NLR increased significantly in RA patients as compared with the healthy controls. In the RA patients, PLR and NLR were positively correlated with the levels of hs-CRP, ESR, IL-6, Disease Activity Score of 28 joints-ESR (DAS28-ESR), anti-cyclic citrullinated peptide (CCP), and rheumatoid factor (RF) before and after tofacitinib treatment. Tofacitinib treatment for 6 months significantly decreased hs-CRP, ESR, IL-6, CCP, RF and DAS28-ESR levels in the RA patients. Conclusion NLR and PLR can be useful biomarkers for assessing disease activity in RApatients treated with tofacitinib.

Key words: neutrophil-lymphocyte ratio; platelet-lymphocyte ratio; rheumatoid arthritis; tofacitinib