摘要
目的分析中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）在不同病因甲状腺毒症中的变化及意义。方法收集2015年1月至2016年12月本院新诊断甲状腺毒症患者1 599例，包括978例Graves病患者（GD组）、452例桥本甲状腺炎患者（HT组）、169例亚急性甲状腺炎患者（SAT组）；以及在本院体检中心健康体检的志愿者1 012名（CON组）。计算各组NLR和PLR值，并分析其与甲状腺功能、生化指标等的相关性。结果SAT组的NLR和PLR显著高于GD组、HT组和CON组（均P〈0.01）；而GD组、HT组和CON组的NLR和PLR水平相似。进一步分析显示，亚急性甲状腺炎患者的NLR与白细胞计数（r＝0.5, P〈0.01）及红细胞沉降率（r＝0.4, P〈0.01）呈正相关；PLR与游离甲状腺素（FT4; r＝0.16, P〈0.05）及红细胞沉降率（r＝0.47, P〈0.01）呈正相关；合并肝损的亚急性甲状腺炎患者的NLR和PLR显著高于肝功能正常者（均P〈0.01）。受试者工作特征曲线分析显示，NLR和PLR诊断亚急性甲状腺炎的界值分别为2.0（敏感性80.5%，特异性76.9%；曲线下面积0.833）和150（敏感性64.3%，特异性84.2%；曲线下面积0.801）。结论NLR和PLR在亚急性甲状腺炎鉴别诊断及预测并发症中具有一定的临床应用价值。
ObjectiveThe neutrophil to lymphocyte ratio （NLR） and platelet to lymphocyte ratio （PLR） have been identified as the biomarkers to predict systemic inflammation. However, there is less study to investigate the association between the biomarkers and thyrotoxicosis.
MethodsA total of 1 012 healthy subjects and 1 599 newly diagnosed thyrotoxicosis patients were enrolled in this study, including 978 in Graves′ disease （GD group）, 452 in Hashimoto′s thyroiditis （HT group）, and 169 in subacute thyroiditis （SAT group） groups. The clinical characteristics were retrospectively extracted from the medical records. The NLR and PLR at the baseline were calculated, the correlations between the NLR, PLR, and the clinical characteristics were analyzed.ResultsThe NLR and PLR in SAT patients were significantly higher than those in the control, GD, and HT groups （all P〈0.01）, but were similar among the last three groups. The NLRs were positively correlated with white blood cell counts （r=0.5, P〈0.01） and erythrocyte sedimentation rates （r=0.4, P〈0.01）, while the PLR was positively correlated with FT4 （r=0.16, P〈0.05） and erythrocyte sedimentation rate （r=0.47, P〈0.01）. The SAT patients with abnormal liver function showed higher NLR and PLR compared the patients with normal liver function （all P〈0.01）. Based on the receiver operating characteristic curve, when to predict SAT patient with autoimmune thyrotoxicosis, the best cutoff value of NLR was 2.0 （sensitivity 80.5%, specificity 76.9%, area under curve 0.833）, and the best cutoff value of PLR was 150 （sensitivity 64.3%, specificity 84.2%, area under curve 0.801）.
ConclusionsThe NLR and PLR values exhibited a dignostic value in the differentiation of SAT from autoimmune thyrotoxicosis.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2017年第6期491-496,共6页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金青年科学基金项目（81200576）
浙江省省自然科学基金青年基金项目（LQ12H07003）
