关键词: 视神经脊髓炎谱系疾病, 中性粒细胞/淋巴细胞计数比值, 嗜酸性粒细胞/淋巴细胞计数比值, 合并其他自身免疫抗体

Abstract:

Objective To investigate the clinical characteristics, neutrophil to lymphocyte ratio and eosinophil to lymphocyte ratio of 61 patients with neuromyelitis optica spectrum disorders (NMOSD). Methods A total of 61 patients admitted to the Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University from June 2017 to June 2021 and diagnosed as acute stage of NMOSD were collected.NMOSD patients’ general clinical information(gender, age), concomitant antibodies were gathered.61 healthy volunteers with matched gender and age were randomly selected from physical examination department as healthy controls(HCs). Routine blood indexes of both groups (neutrophil, eosinophil, monocyte, lymphocyte, platelet, uric acid, cystatin C, C-reactive protein) were collected, and neutrophil to lymphocyte ratio(NLR), eosinophil to lymphocyte ratio(ELR), monocyte to lymphocyte ratio(MLR), platelet to lymphocyte ratio(PLR) were calculated separately according to the above laboratory indicators.The extended disability scale(EDSS) on admission and groups were divided according to the scale results. Cys C, UA, CRP, NLR, ELR, MLR, PLR of NMOSD group and control group, mild- and moderate- severe NMOSD groups were compared.Binary Logistic regression analysis and ROC curve were used analyze the correlation between the above indicators with statistically significant differences and the severity. Results Compared with 61 healthy controls, gender, CRP, NLR, ELR, MLR and PLR of 61 NMOSD patients were statistically significant(P<0.05). In univariate analysis, there were statistically significant differences in the combination of other autoantibodies, NLR and ELR between the mild NMOSD group and moderate severe group(P<0.05). Binary Logistic regression analysis showed, NLR(OR=4.082,95%CI=0.970-7.177,P=0.035), ELR(OR=5.541,95%CI=0.001-8.225,P=0.045), combined with other autoimmune antibodies(OR=0.105,95%CI=0.002-4.997,P=0.038) were independent risk factors affecting the severity in NMOSD patients(P<0.05). NLR combined ELR was the most effective index for evaluating the severity of disease, and the optimal critical value of NLR combined ELR was 0.299, the area under the curve was 0.885, the specificity was 0.765, and the sensitivity was 0.926. Conclusion Patients with other autoimmune antibodies has a significantly high impact on the severity of the disease, and the prognosis is worse.NLR, ELR were effective indicator to evaluate changes in disease severity.

Key words: neuromyelitis optica spectrum disorders, neutrophil to lymphocyte ratio, eosinophil to lymphocyte ratio, combination with other autoimmune antibodies