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来自CBC的炎症指数用于类风湿性关节炎诊断和活动评估:根据血清状况的差异性表现
Jing Zhang1, Yuwei Wang2, Weiduo Nie3
1Department of Rheumatology and Immunology, Peking University International Hospital, Beijing, China.
Frontiers in immunology
|February 6, 2026
概括
像单细胞与淋巴细胞比率 (MLR) 这样的完整血清炎症指数显示出对诊断类风湿性关节炎 (RA) 的希望,但在血清阴性RA病例中,它们的实用性降低了. 系统性免疫炎症指数 (SII) 和系统性炎症反应指数 (SIRI) 有助于评估RA疾病活性.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 生物标志物发现发现
背景情况:
- 类风湿性关节炎 (RA) 是一种全身性自身免疫性疾病,需要改进诊断生物标志物,特别是在血清阴性表现方面.
- 全血清 (CBC) 衍生的炎症指数有可能成为RA的可访问生物标志物.
研究的目的:
- 评估CBC衍生的5个炎症指数 (中性粒细胞与淋巴细胞比率 (NLR),血小板与淋巴细胞比率 (PLR),单细胞与淋巴细胞比率 (MLR),全身免疫炎症指数 (SII) 和全身炎症反应指数 (SIRI)) 在类风湿关节炎 (RA) 中的诊断性能.
- 评估这些指数在区分RA与健康对照和评估疾病活性方面的有用性,包括对血清阳性和血清阴性RA患者的比较.
主要方法:
- 一项追溯病例控制研究,涉及230名RA患者和115名健康对照.
- 从常规血液计数中计算CBC衍生的炎症指数.
- 接收器操作特征 (ROC) 曲线分析以确定诊断准确性 (曲线下的面积[AUC]) 和与疾病活性得分 (DAS28-CRP,SDAI,CDAI) 的相关性.
主要成果:
- 与对照组相比,所有五个CBC衍生的指数在RA患者中都显著升高 (P < 0.001).
- 单细胞与淋巴细胞的比率 (MLR) 显示了RA的最高诊断准确度 (AUC = 0.771),其次是SIRI (AUC = 0.72) 和PLR (AUC = 0.70).
- 在血清阴性RA中,诊断歧视减少,MLR表现最好 (AUC = 0.707). NLR,SII和SIRI与疾病活动标志物相关,并且在活跃的RA中较高,SII和SIRI显示出活跃疾病的最佳歧视 (AUC ≈0.70).
结论:
- 从CBC衍生的炎症指数,特别是MLR,在RA中升高,可以帮助诊断,尽管它们的准确性在血清阴性RA下下降.
- 系统性免疫炎症指数 (SII),系统性炎症反应指数 (SIRI) 和中性粒细胞与淋巴细胞的比率 (NLR) 对于评估RA疾病活性是有价值的.
- 在血清阴性RA中,MLR显示了公平的歧视,而SII,SIRI和NLR在这个子组中具有有限的效用.
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