Correlation Between Neutrophil Lymphocyte Ratio And Neuromyelitis Optica Spectrum Disorder

Background: Neuromyelitis optica spectrum disorder(NMOSD)is an inflammatory demyelinating disease of the central nervous system,which is common in young and strong women.It is mainly involved in the optic nerve and spinal cord,showing a progressive or remission-recurrence process,and the recurrence rate and disability rate are extremely high.It seriously affects the life and work of patients.At present,there are still many questions in the study of the mechanism of inflammatory response in NMOSD.In recent years,it has been found that the neutrophil–lymphocyte-ratio(NLR)is associated with a variety of autoimmune inflammatory responses.At present,there are no detailed reports on NLR and NMOSD.This paper retrospectively analyzes the relationship between NLR and NMOSD disease to explore whether it is related to the inflammatory activity of NMOSD,the recurrence of the disease or the degree of disability.Methods: According to the strict inclusion and exclusion criteria,71 patients with NMOSD were included.According to the recurrence,the patients were divided into recurrence group and remission group.In addition,73 healthy persons in our hospital were randomly selected as the control group.The collected data were as follows: 1.Clinical data: age,sex,extended disability status scale(EDSS),spinal cord MRI,aquaporin-4 antibody(AQP4-Ig G).2.Laboratory data: neutrophil count,lymphocyte count.The following contents were analyzed:(1)to compare the differences between NMOSD patients and healthy controls,(2)to compare the differences between relapse group and remission group of NMOSD patients,and to evaluate the ability of NLR to diagnose NMOSD and predict recurrence.3.According to the EDSS score,the patients were divided into high score(EDSS ≥ 4)and low score(EDSS < 4).The differences between high and low EDSS groups(NLR,sex,age,spinal cord involvement,AQP4-Ig G positive and titer)were compared,and the correlation between these factors and EDSS score was analyzed.Results: 1.Compared with the control group,NLR in the NMOSD group was significantly higher,but there was no significant difference in sex,age,neutrophil absolute value and lymphocyte absolute value.2.Compared with the remission group,the level of NLR in the recurrent group was significantly higher than that in the remission group,but there was no significant difference in the absolute value of neutrophils and lymphocytes.3.The area under the curve of NLR for the diagnosis of NMOSD disease is0.614(95%CI:0.515-0.713),and the critical value is 1.96(sensitivity 72.4%,specificity 49.3%).The area under the curve of NLR for the recurrence of NMOSD disease is 0.684(95%CI:0.552-0.816),and the critical value is2.81(sensitivity 41.4%,specificity 100%).4.Binary logistic regression analysis showed that sex,age and NLR were not independent factors affecting the recurrence of NMOSD disease.5.There was no significant difference in sex,age and average titer of AQP4-Ig G between high and low EDSS groups,but there were significant differences in spinal cord involved segments and NLR between the two groups.Binary logistic regression analysis showed that higher NLR(Coefficient:1.16,95%CI:1.359-15.962,p=0.014)and longer spinal cord involved segments(Coefficient:0.16,95%CI:0.075-0.216,p=0.021)Both of them were independent predictors of the degree of disability progression.Conclusions: 1.The increase of NLR in patients with NMOSD may be related to the inflammatory activity of the disease.2.There is no direct correlation between NLR and the recurrence of NMOSD.3.The increase of NLR may indicate that the degree of disability in patients with NMOSD is more serious.