To investigate the value of peripheral blood cell count ratio in evaluating disease activity and efficacy in patients with rheumatoid arthritis (RA).

The clinical data of 116 patients with RA who met the diagnostic criteria and did not receive relevant treatment in the First People's Hospital of Suqian City from October 2019 to October 2020 were retrospectively analyzed as the observation group, cardiac or hepatic-renal insuffiencies, hematological or immune system diseases, and malignant tumors were excluded; 96 healthy volunteers were selected as the control group at the same time. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and lymphocyte/monocyte ratio (LMR) were calculated. According to the 28 joint disease activity score (DAS28), patients were divided into the remission group and active group; then the patients in remission group were divided into effective group and invalid group according to the therapeutic effects after treatment. Variance analysis was used for comparison between multiple groups, and independent sample t test was used for comparison between two groups. Logistic regression was used to analyze clinical data to determine the influencing factors of RA disease activity, and the correlation between NLR, PLR, LMR and disease activity and the changes before and after treatment were analyzed. Receiver operating characteristic curve (ROC) and area under curve(AUC) of it was used to evaluate the predictive value of NLR, PLR and LMR in RA disease activity and outcomes.

According DAS28, 32 patients were in remission group and 84 were in active group. The levels of NLR and PLR in active group were higher than those in remission group, while the levels of LMR were lower than those in remission group, with statistically significant differences (t=3.957, 6.336, 3.696, all P<0.001). The AUC of NLR, PLR and LMR for disease activity in RA patients were 0.835, 0.810 and 0.812, respectively. The sensitivities were 88.9%, 69.1% and 67.9%, and the specificities were 74.3%, 77.1% and 85.7%, respectively. According to therapeutic effects, 53 patients were in effective group and 31 were in invalid group. The NLR and PLR values of the effective group were lower than those of the ineffective group, and the LMR values were higher than those of the ineffective group, with statistical significance (t=3.493, 4.536, 3.742, all P<0.01). The AUC of NLR, PLR and LMR for RA patients was 0.777, 0.749 and 0.783 respectively; the sensitivity was 65.6%, 59.4% and 65.7%, and the specificity was 85.7%, 85.7% and 77.5%, respectively.

NLR, PLR and LMR are independent influencing factors of disease activity in patients with RA. They are effective and simple in evaluating disease activity and efficacy, and can be used as reference index for long-term clinical monitoring of RA disease.