摘要
目的探讨中性粒细胞/淋巴细胞比值(neutrophilto lymphocyte ratio,NLR)、CD4^+/CD8^+T淋巴细胞比值和白介素6(interleukin-6,IL-6)单独及联合检测对慢性阻塞性肺疾病急性加重期的预测价值,为临床诊治提供参考依据。方法随机选取2018年1月至2018年12月在我院确诊的慢性阻塞性肺疾病患者312例为研究对象,根据病情又分为急性加重期组176例和稳定期组136例,另选取同期健康体检者60例为健康对照组,分别检测各组NLR、CD4^+/CD8^+T淋巴细胞比值和IL-6进行比较分析,将各指标进行非条件Logistic回归分析确定是否为危险因素,采用受试者工作特征(ROC)曲线评价各项指标的预测价值。结果急性加重期组的NLR和IL-6水平均明显高于稳定期组和对照组,而CD4^+/CD8^+T淋巴细胞比值明显低于稳定期组和对照组,差异有统计学意义(P<0.05),稳定期组的NLR和IL-6水平也均明显高于对照组,CD4^+/CD8^+T淋巴细胞比值低于对照组,差异有统计学意义(P<0.05),NLR和IL-6为慢性阻塞性肺疾病急性加重的危险因素,偏回归系数分别为1.039、0.374(P<0.05)。三指标联合检测预测慢性阻塞性肺疾病急性加重的ROC曲线下面积(AUC)为0.977,明显高于各指标单独检测及两指标联合检测。三指标联合检测预测慢性阻塞性肺疾病急性加重具有最高的灵敏度和特异性,分别为94.3%和91.6%,Youden指数为0.936。结论NLR、CD4^+/CD8^+T淋巴细胞比值和IL-6是预测慢性阻塞性肺疾病急性加重的有效指标,三指标联合检测对评估慢性阻塞性肺疾病的严重程度及指导治疗有重要的临床意义。
Objective To explore the predictive value of neutrophil/lymphocyte ratio(NLR),CD4^+/CD8^+T lymphocyte ratio and interleukin-6(IL-6)in acute exacerbation of chronic obstructive pulmonary disease(COPD)when applied alone or in combination,so to provide a reference for clinical diagnosis and treatment.Methods 312 patients with chronic obstructive pulmonary disease diagnosed in our hospital from January,2018 to December,2018 were randomly selected as the study subjects.According to their conditions,these patients were divided into the acute exacerbation group(176 cases)and the stable stage group(136 cases).Another 60 healthy people in the same period were selected as the healthy control group.The ratio of NLR,CD4^+/CD8^+T lymphocyte and IL-6 in each group was detected,and the results were compared and analyzed among groups.The unconditional logistic regression analysis was used to determine whether these indicators were risk factors,and ROC curve was used to evaluate the predictive value of these indicators.Results The levels of NLR and IL-6 in the acute exacerbation group were significantly higher than those in the stable group and the control group,while the ratio of CD4^+/CD8^+T lymphocyte was significantly lower than that in the stable group and the control group(P<0.05).The levels of NLR and IL-6 in the stable group were also significantly higher than those in the control group,while the ratio of CD4^+/CD8^+T lymphocyte was lower than that in the control group.NLR and IL-6 were risk factors for acute exacerbation of chronic obstructive pulmonary disease,with partial regression coefficients of 1.039 and 0.374,respectively(P<0.05).The area under the ROC curve(AUC)of the combined detection of three indicators for predicting acute exacerbation of COPD was 0.977,which was significantly higher than that of the single detection of each indicator and the combined detection of two indicators.The highest sensitivity and specificity were 94.3%and 91.6%,respectively,and Youden index was 0.936.Conclusion NLR,CD4^+/CD8^+T lymp
作者
孟凡飞
李毅
孟凡娜
张立群
项贵明
MENG Fanfei;LI Yi;MENG Fanna;ZHANG Liqun;XIANG Guiming(Laboratory Department,Second Affiliated Hospital of Army Medical University,Chongqing 400037,China;Health Examination Center of the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)
出处
《标记免疫分析与临床》
CAS
2020年第9期1468-1472,共5页
Labeled Immunoassays and Clinical Medicine
基金
陆军军医大学科技创新能力提升专项基金(编号:2019XLC3015)。
