摘要
目的探讨中性粒细胞淋巴细胞比率(NLR)在慢性阻塞性肺疾病急性加重期的变化及其临床价值。方法收集2017年1月—2018年5月期间于郑州大学第一附属医院就诊的共135名慢性阻塞性肺疾病(COPD)患者,其中稳定期(SCOPD组)75人,加重期(AECOPD组)60人,对照组为同期体检的34名健康人员,均于清晨空腹状态下采集病例组与对照组的血常规及C-反应蛋白(CRP),比较三组中性粒细胞计数(N)、淋巴细胞计数(L)、中性粒细胞比率(N%)、淋巴细胞比率(L%)、中性粒细胞淋巴细胞比率(NLR)及CRP水平,运用相关分析探讨COPD组患者NLR与CRP的相关性,以受试者工作(ROC)曲线分析NLR及CRP预测慢性阻塞性肺疾病急性加重的最佳切点。结果 AECOPD组NLR(6.21±2.83)高于SCOPD组(2.08±0.89)及对照组(1.71±0.65),差异有统计学意义(F=106.96,P=0.00);AECOPD组N(6.39±3.02)×10^(9)/L、N%(74.6±9.59)%、CRP水平(50.6±7.06)mg/L高于SCOPD组N(3.60±1.15)×10^(9)/L、N%(54.9±10.2)%、CRP水平(2.63±0.34)mg/L和对照组N(3.39±1.03)×10^(9)/L、N%(55.0±7.86)%、CRP水平(1.81±0.18)mg/L,差异有统计学意义(P均<0.001);AECOPD组L(1.13±0.39)×10^(9)/L、L%(14.8±7.38)%均低于SCOPD组L(1.92±0.69)×10^(9)/L、L%(30.0±7.83)%和对照组L(2.07±0.46)×10^(9)/L、L%(34.5±7.13)%,差异有统计学意义(P均<0.001);Pearson相关分析示,AECOPD组NLR与CRP成正相关(r=0.555P<0.001),SCOPD组NLR与CRP成正相关(r=0.365P=0.001);ROC曲线示,NLR曲线下面积为0.948,CRP曲线下面积为0.996(P<0.001),NLR预测AECOPD的最佳切点为3.53,CRP最佳切点为9.147 mg/L。结论 NLR与慢性阻塞性肺疾病的急性加重相关,可以作为慢性阻塞性肺疾病急性加重的炎性标志物。
Objective To explore the change of neutrophil-lymphocyte ratio(NLR)in exacerbation of chronic obstructive pulmonary disease and its predictive value of the exacerbation of chronic obstructive pulmonary disease.Methods A study of 135 patients with COPD who visited the First Affiliated Hospital of Zhengzhou University which of 75 patients at stable period and 60 patients during acute exacerbation, as well as 34 healthy controls. All participants were examined blood routine and C-reactive protein to compare their neutrophil count,lymphocyte count,neutrophil ratio,lymphocyte ratio,NLR and the level of CRP,correlation analysis to explore the relationship between NLR and CRP. Receiver operating curve was conducted to obtain a cut-off value of NLR and CRP for predicting AECOPD. Results The NLR of the AECOPD group(6.21±2.83)was higher than that of SCOPD group(2.08±0.89)and the control group(1.71±0.65), there was significant difference among the three groups(F=106.96,P=0.00).Compared with SCOPD group and control group, Neutrophil count(6.39±3.02)×10^(9)/L, neutrophil ratio(74.6±9.59)% and the level of C-reactive protein(50.6±7.06)mg/L in AECOPD group were higher than those in SCOPD group, Neutrophil count(3.60±1.15)×10^(9)/L, neutrophil ratio(54.9±10.2)%, the level of C-reactive protein(2.63±0.34)mg/Land the control group,Neutrophil count(3.39±1.03)×10^(9)/L, neutrophil ratio(55.0±7.86)%,the level of C-reactive protein(1.81±0.18)mg/L, respectively. The difference was statistically significant.(P<0.001).While lymphocyte count(1.13±0.39)×10^(9)/L and lymphocyte ratio(14.8±7.38)% in AECOPD group were lower than the SCOPD group, lymphocyte count(1.92±0.69)×10^(9)/L, lymphocyte ratio(30.0±7.83)% and the control group, lymphocyte count(2.07±0.46)×10^(9)/L,lymphocyte ratio(34.5±7.13)%, respectively. The difference was statistically significant.(P<0.001). Pearson correlation analysis showed that positive relation were observed between NLR and CRP among SCOPD group(r=0.365P=0.001) and AECOPD group(r=0.555P<0.001).The cut-off point of NLR for predicting AECOPD was 3.53 and the cut-off point of CRP level was 9.147 mg/L as shown in ROC curve.Conclusion The NLR was associated with the exacerbation of chronic obstructive pulmonary disease and it could be the inflammatory marker of AECOPD.
作者
刘菊敏
蒋军广
邹亚宁
罗俊芳
LIU Ju-min;JIANG Jun-guang;ZOU Ya-ning;LUO Jun-fang(The First affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《医药论坛杂志》
2021年第2期35-39,共5页
Journal of Medical Forum
