Changes And Clinical Significance Of Hematological Parameters In Inflammatory Bowel Disease

Objective:To discuss the efficacy of platelet count(PLT),mean platelet volume(MPV),red blood cell distribution width(RDW),neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in evaluating activity in inflammatory bowel disease(IBD).Methods:Two hundred and six patients with inflammatory bowel disease admitted to the north district gastroenterology department of suzhou municipal hospital from January 2017 to December 2019 were included as the study subjects,including one hundred and thirty-three patients with crohn's disease(CD)and seventy-three patients with ulcerative colitis(UC).Meanwhile,one hundred and twelve physical examinees were randomly selected as the normal control group.To observe the difference of hematological parameters between IBD patients and control group and the change of hematological parameters in different stages of IBD.The correlation between the above indicators and disease activity indicators was analyzed,and the corresponding receiver operating characteristic curve was drawn to evaluate the application value of PLT,MPV,RDW,NLR and PLR in different disease stages of IBD.Results:(1)The levels of PLT,RDW,NLR and PLR in the UC and CD groups were higher than those in the control group(P<0.05),while the levels of MPV were lower than those in the control group(P<0.001).(2)The PLT,NLR,PLR and RDW in the active UC group and the CD group were all higher than that in the remission stage(P<0.05),and the MPV was lower than that in the remission stage(P<0.05).(3)There were statistical differences in PLT,RDW,NLR,PLR and MPV levels between the CD group and the UC group in different disease stages(remission,mild activity,moderate activity and severe activity)groups(P<0.05).(4)PLT,RDW,NLR and PLR in UC group were positively correlated with the inflammatory index(hs-CRP,ESR and Mayo score),respectively(r>0.3,P<0.01),while MPV was negatively correlated with hs-CRP,ESR and Mayo score,respectively(r<-0.4,P<0.001).In the CD group,PLT,NLR and PLR were positively correlated with hs-CRP,ESR and CDAI score,respectively(r>0.3,P<0.001),while MPV was negatively correlated with hs-CRP,ESR and CDAI score,respectively(r<-0.3,P<0.001).(5)The sensitivity and specificity of PLT for active UC were 73.3%and 61.5%,RDW were 90%and 53.8%,NLR were 56.7%and 92.3%,PLR were 50%and 92.3%,MPV were 61.7%and 76.9%,respectively.The sensitivity and specificity of PLT for active CD were 63.8%and 68.7%,RDW were 60.9%and 68.7%,NLR were 66.7%and 62.5%,PLR were 73.9%and 59.4%,MPV were 59.4%and 71.9%,respectively.(6)Among the above indexes,PLR and NLR had better efficacy in evaluating IBD disease activity,but all of them were slightly lower than hs-CRP.The efficacy of combining PLR,NLR and hs-CRP to judge IBD activity was better than that of independent evaluation,with the highest evaluation value.(7)In addition,we found that the total bilirubin levels of the UC group and the CD group were lower than those of the control group.Conclusions:PLR,NLR,PLT and RDW increased in patients with IBD,while MPV decreased,and the above indicators were different in different disease stages of IBD.PLR,NLR,PLT,RDW and MPV were related to the disease activity of IBD,which could be used as an indicator to monitor the disease activity of IBD.The combination of PLR,NLR and hs-CRP is of higher value in the determination of IBD disease activity.