Neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as predictors of MS severity: a retrospective cohort study

Sabah E. Fathy, Amany M. AbdAllah, Rania Y. Helal
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Abstract

Multiple sclerosis (MS) is a disabling immune-mediated disease of the central nervous system. Ministry of Health and Population’s statistics show that MS comprise 1.4% of all neurological diseases, putting into consideration, current economic crisis; it is needed to predict disease severity with an acceptable cost-effective method. Complete blood count (CBC) parameters are supposed to be cheap, and simple markers for the systemic inflammatory state. This study aims at evaluating role of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in predicting the severity of MS. Therefore, this retrospective cohort study was done on 150 MS patients attending MS clinic during year 2022. All patients were subjected to complete medical history. Estimation of the disability was done through the extended disability status scale (EDSS) and analysis of different parameters of baseline CBC before starting therapy. A cutoff value of NLR ≥ 2.95 and PLR ≥ 201.5 could predict prognosis of MS. Risk factors of sever MS are high NLR, PLR, high body mass index and absence of disease-modifying therapy. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are cheap valid useful predictors of increased relapse rate and severity in MS. Highlighting the role of both ratios at time of first diagnosis helps physicians to predict prognosis of patients in context of severity. Paying special attention to those with higher ratios can lead to improve patient outcome and reducing disease burden.
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预测多发性硬化症严重程度的中性粒细胞-淋巴细胞比率和血小板-淋巴细胞比率:一项回顾性队列研究
多发性硬化症(MS)是一种由免疫介导的中枢神经系统致残性疾病。卫生和人口部的统计数据显示,多发性硬化症占所有神经系统疾病的 1.4%,考虑到当前的经济危机,需要用一种可接受的经济有效的方法来预测疾病的严重程度。全血细胞计数(CBC)参数应该是系统炎症状态的廉价而简单的标记。本研究旨在评估中性粒细胞-淋巴细胞比值(NLR)和血小板-淋巴细胞比值(PLR)在预测多发性硬化症严重程度中的作用。因此,这项回顾性队列研究针对 2022 年期间在多发性硬化症诊所就诊的 150 名多发性硬化症患者。所有患者均接受了完整的病史检查。通过扩展残疾状态量表(EDSS)估算残疾程度,并分析开始治疗前基线白细胞计数的不同参数。NLR≥2.95和PLR≥201.5的临界值可预测多发性硬化症的预后。严重多发性硬化症的风险因素是高 NLR、PLR、高体重指数和未接受疾病修饰治疗。中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值是预测多发性硬化症复发率和严重程度的有效指标。强调首次诊断时这两个比率的作用有助于医生根据严重程度预测患者的预后。特别关注血细胞比值较高的患者,可以改善患者的预后,减轻疾病负担。
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