الفهرس 
AbstractOnly 14 pages are availabe for public view
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Abstract
Neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio (PLR), and neutrophil CD64 expression are all inflammatory markers that may that reflect the activity of many inflammatory diseases.
We aim to evaluate the NLR, PLR and neutrophil CD64 expression as potential markers of disease activity in patients with ankylosing spondylitis
In the study, there were 32 patients who had ankylosing spondylitis matched age and sex with 15 healthy controls. Every patient did a complete blood count (CBC), a study of neutrophil CD64 expression, an erythrocyte sedimentation rate (ESR), a C-reactive protein (CRP), and a plain X-ray of the lumbosacral spine and sacroiliac joints. The BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), ASDAS (Ankylosing Spondylitis Disease Activity Score), BASMI (Bath Ankylosing Spondylitis Metrology Index), and BASFI (Bath Ankylosing Spondylitis Functional Index) are used to measure the disease activity of all patients. The patients were split into two groups based on their BASDAI scores: those with inactive disease (BASDAI < 4) and those with active disease (BASDAI ≥ 4). The correlations between the NLR, PLR, neutrophil CD64 expression, ESR and CRP and disease activity were analysed.
In this research we found a significant difference in NLR between active AS patients and inactive AS patient (P<0.001) and between Active AS patient and Controls (P<0.0001), between three groups (P<0.0001) and there is no significant difference between inactive AS patient and Control.
There was a significant difference in PLR between active AS patients and inactive AS patient (P< 0.001) and between Active AS patient and Controls (P< 0.001) and there is no significant difference between three groups or between inactive AS patient and Control.
There was no significant difference in neutrophil CD64 expression between active AS patient and inactive AS patient and between active AS patient, inactive AS patient and controls.
There was statistically significant deference in ESR and CRP between inactive and active AS patients (P<0.009, <0.033) respectively, between active group and control (P<0.0001) and between three groups (p<0.001, <0.001) respectively, while there was statistically significant deference between active patients and control regarding ESR only (p<0.038).
There was positive correlation between the BASDAI scores and NLR, PLR, ESR and CRP (P<0.0001, <0.001, <0.015, < 0.001) respectively, but it was no correlation with the neutrophil CD64 expression.
Based on the ROC curve, it was found that the NLR had an optimal sensitivity of 82.35%, specificity of 80 and accuracy of 81.25% with a cut-off value of 1.15, while PLR had an optimal sensitivity of 94.12%%, specificity of 60% and accuracy of 78.12%%% with a cut-off value of 90.5.
Conclusion
Our study showed significant difference in the neutrophil/ lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) between active and inactive AS patients and between active AS patients and controls, However there was no statistically significant difference between active and inactive AS patients or between AS patients and controls regarding neutrophils CD64 expression.
Also we found a significant positive correlation between disease activity and NLR and PLR, while there was no significant correlation between disease activity and neutrophils CD64 expression.
Recommendations
- The NLR and PLR are important, fair, and reliable tests that can tell the difference between active and inactive AS patients. Neutrophil CD64 expression, on the other hand, was found to be unuseful.
- Future research with a bigger sample size and longer follow-up times is needed to support the results of this study.
- Due to their higher amounts in active patients and their association with the BASDAI score, we think that NLR and PLR, along with the ESR, may be helpful in figuring out how active the disease is in patients with AS.
- These are simple, fast, and cheap tests whose results are easy to estimate and they are needed parts of the complete blood count (CBC) test, which is now done regularly in almost all medical facilities.