The Predictive Value Of Platelet/Lymphocyte Ratio,Neutrophil/Lymphocyte And Lymphocyte/Monocyte Ratioin Rheumatoid Arthritis With Interstitial Lung Disease

Objective: The purpose of this study is to statistically analyze the hematological indexes of patients with Rheumatoid arthritis(RA),and to explore the clinical correlation analysis of hematological indexes in RA patients with Interstitial lung disease(ILD)and the evaluation of its predictive value.Methods: The clinical data of 118 RA patients hospitalized in Yanbian University Affiliated Hospital from January 2011 to November 2020 were collected and divided into non-RA-ILD group and RA-ILD group according to whether ILD was combined or not.The general clinical data,hematological indexes(platelets,neutrophils,lymphocytes,monocytes),biochemical indexes and immunological indexes of RA patients and 118 healthy people were statistically analyzed.By analyzing the correlation between Platelet to lymphocyte ratio(PLR),Neutrophil to lymphocyte ratio(NLR)and Lymphocyte to monocyte ratio(LMR)and clinical laboratory indicators,the clinical predictive value of RA patients with ILD was evaluated.Results: 1.Comparison of general clinical data: There are 53 RA with ILD among 118 RA patients and the incidence of ILD was 44.92%.There was no significant difference in sex among non-RA-ILD group,RA-ILD group and normal control group(P>0.05).There is no statistical difference in average age between RA group and normal control group(P>0.05),but there is statistical difference between non-RA-ILD group and RA-ILD group(P<0.05).2.Comparison of laboratory indexes: The levels of platelet,neutrophil,PLR,NLR,ESR and CRP in RA-ILD group and non-RA-ILD group were higher than those in normal control group,and the difference was statistically significant(P<0.05),while the level of LMR was lower than that in normal control group(P<0.05).The ratio of platelet,neutrophil,monocyte,NLR and Anti-CCP in RA-ILD group was higher than that in non-RA-ILD group(P<0.05),and the LMR was lower than that in non-RA-ILD group(P<0.05).3.Comparison of hematological indexes: PLR in RA patients was higher than that in normal control group(P<0.05),but there was no statistical difference in patients with ILD(P > 0.05).Compared with non-RA-ILD group,RA-ILD group and normal control group,the difference was statistically significant(P<0.05).NLR in RA patients was higher than that in normal control group,and the difference was statistically significant(P<0.05).Patients with ILD had higher NLR level(P<0.05).There was significant difference in LMR among the three groups(P<0.05).LMR in RA patients was lower than that in normal control group,and the difference was statistically significant(P<0.05).The LMR level of patients with ILD was lower(P<0.05).4.Correlation analysis: PLR was positively correlated with ESR(r=0.427,P<0.001),and PLR was positively correlated with CRP(r=0.402,P<0.001).The NLR of RA patients was positively correlated with ESR(r=0.254,P =0.005),and NLR was positively correlated with CRP(r=0.278,P =0.002).5.Binomial Logistic regression analysis: NLR was an independent predictor for RA patients(OR 1.670,95%CI:1.192-2.338;P=0.003).6.ROC curve analysis: In predicting RA in normal people,the Cutoff value of PLR is 166.830(sensitivity 51.7%,specificity 94.1%,AUC=0.781),the Cutoff value of NLR is 2.190(sensitivity70.3%,specificity 77.1%,AUC=0.780),and LMR is 2.190.In predicting whether RA patients are complicated with ILD,the Cutoff value of NLR is 2.885(sensitivity 75.5%,specificity 69.2%,AUC=0.747),and the Cutoff value of LMR is 3.120(sensitivity 58.5%,specificity 78.5%,AUC=0.692).Conclusion: 1.PLR,NLR and LMR can be used as hematological parameters to predict the disease of RA;2.NLR and LMR can be used as important parameters to predict ILD in RA patients.