| Background: Rheumatoid arthritis(RA)is a chronic inflammatory autoimmune arthritis.The main pathological features are synovitis,bone erosion and pannus.The lesions are mainly concentrated in synovial tissue,cartilage and bone,and the main clinical manifestations are symmetric joint pain and swelling.The most commonly used assessment tool for the disease activity of RA is Disease Activity Score-28(DAS28),but the calculation of DAS28 requires erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),pain score(VAS),tenderness and swelling of joints,and the calculation is cumbersome,and ESR and CRP have a large weight in the calculation formula,but they are also affected by non-RA factors such as tumor,anemia,renal failure,infection,etc.Therefore,the accuracy is controversial.Find a marker that is related to the disease activity of RA and is convenient to obtain very important.At present,indicators such as red cell distribution width(RDW),mean platelet volume(MPV),neutral lymphatic ratio(NLR),mononuclear lymphatic ratio(MLR),Platelet to lymphocyte ratio(PLR)and platelet distribution width(PDW)have been proved by relevant studies to be related to ankylosing spondylitis,white blood The disease activity of rheumatoid immune diseases such as RA and systemic lupus erythematosus is related to disease activity.However,there are few studies on peripheral blood cell parameters such as RDW,MPV,PLR,NLR,MLR and disease activity of RA.Aim:To explore whether RDW,MPV,NLR,PLR,and MLR can be used as one of the inflammatory markers of RA,with predictive value for RA disease activity,and can be associated with inflammatory indicators such as ESR and CRP.Methods: From December 2019 to December 2021,107 patients with RA who were admitted to the Department of Rheumatology and Immunology,Zhuzhou Hospital,Xiangya School of Medicine,Central South University were selected and included in the RA group(female/male,81/26),65 healthy people who had undergone physical examination in the health examination center were included healthy group(women/men,47/18).According to DAS28 of patients with RA,patients with RA were divided into low disease activity group(DAS28≤3.2),moderate activity group(3.2<DAS28≤5.1),and high activity group(5.1<DAS28).The RDW,MPV,PLR,NLR,MLR,PDW and other indicators of the above groups were compared using T test or one-way ANOVA respectively.Spearman and Pearson correlation analysis was used to analyze the correlation between RDW,MPV,PLR,NLR,MLR,PDW and laboratory indexes in patients with RA.Multivariate logistic regression was used to analyze the correlation between RDW,MPV,PLR,NLR,MLR,PDW and RA disease activity.Results: 1.Comparing RA group with the healthy group: RDW,MPV,PLR,NLR,MLR,RBC,PLT and HGB were different between the two groups(P<0.05).Among them,the values of MPV,RBC and HGB in the RA group were significantly lower than those in the healthy group(P<0.05),while the values of RDW,PLR,NLR,MLR and PLT were higher than those in the healthy group(P<0.05).2.There was a negative correlation between MPV and CRP(P<0.05);there was a positive correlation between PLR,NLR,MLR,WBC and PLT and CRP(P<0.05).The relationship between NLR and CRP was the most significant;3.There was a negative correlation between HGB and ESR(P<0.05);there was a positive correlation between PLR,NLR,MLR,WBC and PLT and ESR(P<0.05);There was no significant relationship between RDW,MPV,RBC and ESR;5.There was no significant relationship between whole blood index and disease activity in RA patients.The current evidence does not support the use of whole blood index to predict disease activity in RA patients.Conclusion: RDW,NLR,PLR and other indicators are convenient and inexpensive inflammatory indicators,which are linearly correlated with CRP and ESR in RA patients,and can be used as one of the auxiliary inflammatory indicators that are consistent with CRP and ESR.Existing data do not support the ability to assess and predict disease activity in RA patients. |
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