目的：確定肉芽腫性多動脈炎(GPA)患者的中性粒細胞/淋巴細胞比(NLR)，並研究其與疾病表現和活動性的相關性。

        方法：研究納入了44名GPA患者和44名性別和年齡匹配的對照。采集完整病史，進行全麵臨床檢查，重點行口腔、實驗室和影像學檢查。使用伯明翰血管炎活動性評分表 (BVAS)評估疾病活動性。

        結果：患者(21 男、 23 女) 平均年齡45.66±7.24 歲, 病程6.8±3.6 年，平均BVAS評分 50.1±14.3。所有患者胞漿型抗中性粒細胞胞漿抗體(c-ANCA)陽性，隻有5名患者p-ANCA陽性。GPA患者的MLR(5.1±2.4)顯著高於對照(1.5±0.8) (P<0.0001)。10名伴有色素膜炎的患者NLR (6.5±1.9)顯著高於不伴有色素膜炎者 (4.7±2.4) (P=0.03)。而突眼患者 (n=10)、有皮膚表現患者 (n=17) 或缺血性心髒病 (n=9)者 NLR顯著低於無這些表現者 (P值分別為P=0.0001、P=0.017和P=0.046)。 NLR 與患者的臨床特點無顯著相關性。NLR與疾病活動性負相關但無統計學差異 (r=-0.02，P=0.93)。

        結論：NLR可能在GPA發病中有至關重要的作用，參與色素膜炎或突眼、皮膚表現和缺血性心髒病。NLR可能作為一個未來的對GPA診斷和評估有用的類似於c-ANCA陽性的指標，可能在組織特異性和臨床特點中其作用。

        原 文

        Abstract

        Object:To determine toneutrophil-to-lymphocyte ratio (NLR) in granulomatosis with polyangiitis (GPA)patients and to study its relation to disease manifestations and activity.

        METHODS:Thestudy included 44 GPA patients and 44 matched age and sex controls. Fullhistory taking, thorough clinical examination with more attention to ocularexamination, laboratory and radiological investigations were considered.Disease activity was assessed using the Birmingham Vasculitis Activity Score (BVAS).

        RESULTS:Thepatients (21 males and 23 females) had a mean age of 45.66±7.24 years, diseaseduration 6.8±3.6 years and BVAS 50.1±14.3. All patients had a positivecytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) while only 5 had apositive p-ANCA. The NLR was significantly increased in the GPA patients(5.1±2.4) compared to the control (1.5±0.8) (P<.0001). Ten patients withuveitis had a significantly higher NLR (6.5±1.9) compared to those without(4.7±2.4) (0.03) while those with proptosis (n=10), cutaneous manifestations(n=17) or ischemic heart disease (n=9) had a significantly lower NLR than thosewithout (P=.0001, P=.017 and P=.046 respectively). The NLR did notsignificantly correlate with any of the patients' characteristics. The NLRinversely yet insignificantly correlated with the disease activity (r=-0.02,P=.93).

        CONCLUSION:TheNLR may have a significant role in the pathogenesis of GPA, the development ofuveitis or proptosis, cutaneous manifestations and ischemic heart disease. NLRmay serve as a future potential companion to c-ANCA positivity in diagnosingand evaluating GPA and may play a role in the tissue-specific and clinicalcharacteristics.

        引自：Abaza NM,El-Latif EMA,Gheita TA.Clinical Significance ofNeutrophil/lymphocyte Ratio in Patients With Granulomatosis With Polyangiitis. Reumatol Clin.2017 Dec 20. pii: S1699-258X(17)30277-2. doi:10.1016/j.reuma.2017.11.003. [Epub ahead of print]