Romatoid Artritte Nötrofil/ Lenfosit ve Platelet/ Lenfosit Oranlarının Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, romatoid artrit (RA), hastalık aktivitesi ile hematolojik parametrelerden nötrofil-lenfosit oranı (NLO), platelet lenfosit oranı (PLO) ve eritrosit dağılım genişliği (RDW) arasındaki ilişkiyi incelemektir. Yöntemler: Yetmiş yedi romatoid artrit hastası ve 97 sağlıklı bireyden oluşmuş kontrol grubu bu retrospektif çalışmaya dâhil edildi. Kontrol grubuna sistemik ve kronik herhangi bir hastalığı olan kişiler dâhil edilmedi. Hastaların hastalık aktivite skorları (DAS 28) ve her iki grubun hematolojik parametreleri ve inflamasyon parametreleri istatistiksel olarak Student-t testi ve Spearman korelasyon testiyle karşılaştırıldı. Bulgular: Yaş ve cinsiyet açısından gruplar arasında fark yoktu. C-reaktif protein (CRP) ve eritrosit sedimentasyon hızı (ESH) seviyeleri RA hasta grubunda anlamlı olarak yüksekti (p<0,001). RA hasta grubunda hemoglobin ve ortalama platelet hacmi (MPV) düzeyleri anlamlı olarak düşük bulunurken (sırasıyla; p<0,001, p=0,022) , trombosit, RDW, NLO ve PLO ise anlamlı olarak yüksek bulundu (sırasıyla; p<0.001, p<0.001, p<0,001, p<0,001). Hasta grubunda farklı hastalık aktivitesi seviyelerinde (DAS 28) ESH (p<0,001), mutlak nötrofil (p=0,04), trombosit (p=0,019) seviyeleri anlamlı olarak yüksekken, lenfosit (%) (p=0.042) seviyeleri anlamlı olarak düşüktü. PLO düzeyleri ile MPV düzeyleri (r=-0,386) negatif anlamlı korelasyon gösterirken, RDW seviyeleri (r=0,354) ve NLO düzeyleri (r=0,618) ile anlamlı pozitif korelasyon göstermekteydi. Sonuç: Romatoid artrit hastalık aktivitesinin değerlendirilmesinde NLO ve PLO doğru sonuçlar verirken, klinik pratikte kullanışlı bir parametre olabilirler. Geniş katılımlı çalışmalarla bu parametreler ile hastalık şiddetinin belirlenmesinde daha özgül endeksler geliştirilebilir.

Keywords

• Nötrofil lenfosit oranı (NLO), platelet lenfosit oranı (PLO), eritrosit dağılım genişliği (RDW), romatoid artrit (RA), enflamasyon

Evaluation of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios in Rheumatoid Arthritis

Abstract

Objective: The purpose of this study is to investigate the relationship of disease activity with Neutrophil-Lympho­cyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) and red blood cell distribution width (RDW). Methods: Seventy seven RA patients and 97 healthy sub­jects were examined retrospectively. People with chronic and systemic diseases were excluded from control group of the study. The disease activity scores (DAS 28) of pa­tient group, hematologic parameters and inflammation parameters of both groups were analyzed statistically us­ing independent t-test and spearman correlation test. Results: Age and gender was not found different be­tween groups. CRP and ESR levels were significantly higher in RA group (p<0.001). Hemoglobin and platelet count were lower (p<0.001 and p=0.022), while RDW, NLR, PLR and MPV levels were significantly higher in RA group (p<0.001, p<0.001. p<0.001, p<0.001, respec­tively). In patient group, ESR (p<0.001), lymphocytes (%) (p= 0.042), absolute neutrophil (p=0.047), and platelets (p= 0.019) were positively, whereas lymphocytes were negatively affected by improvement disease activity (DAS 28) scores. PLR levels significantly negatively correlated with MPV levels (r= -0.386) but showed a significant posi­tive correlation with RDW (r= 0.354) and NLR levels (r= 0.618). Conclusion: NLR and PLR are important and promising factors for disease activity estimation of rheumatoid ar­thritis and may be used in clinical practice. In our opinion, larger studies consisting larger group will help determina­tion of disease activity of RA by more specific indices us­ing these parameters.

Keywords

• Neutrophil-lymphocyte ratio (NLR), Platelet Lymphocyte Ratio (PLR), Red blood cell distribution width (RDW), Rheumatoid arthritis (RA), İnflammation

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