摘要
目的观察中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)在不同血嗜酸性粒细胞(EOS)水平慢性阻塞性肺疾病(简称慢阻肺)患者中的差异,并探讨其在不同EOS水平的慢阻肺患者中对病情急性加重的预测效能。方法慢阻肺急性加重期患者662例(加重组)、稳定期患者335例(稳定组),根据患者血EOS水平分为三亚组,低EOS(≤100/μL)亚组、中EOS(100/μL<EOS<300/μL)亚组、高EOS(≥300/μL)亚组。比较各组NLR、PLR之间的差异,不同EOS亚组中,分析NLR、PLR与肺功能之间的相关性,并通过受试者工作特征曲线(ROC)分析NLR、PLR对慢阻肺急性加重期的预测效能。结果①加重组中,低、中、高EOS亚组NLR分别为3.42、2.86、2.34,PLR分别为129.07、115.03、107.96,低EOS亚组NLR、PLR高于中、高EOS亚组(P均<0.05);稳定组中,低、中、高EOS亚组NLR分别为2.41、2.22、2.20,PLR分别为128.00、117.82、109.30,低EOS亚组NLR高于中、高EOS亚组,低EOS亚组PLR高于高EOS亚组(P均<0.05)。加重组中位NLR为3.09,高于稳定组2.29(P<0.05),而PLR差异无统计学意义。在中、低EOS亚组中,加重组NLR高于稳定组(P<0.05),但在高EOS亚组间差异无统计学意义。②低EOS亚组中,NLR与FVC、FVC%、FEV1、FEV1%、FEV1/FVC呈负相关(P均<0.05);中EOS亚组中,NLR与FVC、FVC%、FEV1、FEV1%、FEV1/FVC呈负相关(P均<0.05),PLR与FEV1%呈负相关(P<0.05);高EOS亚组中,NLR仅与FEV1/FVC呈负相关(P<0.05)。③NLR预测慢阻肺急性加重的最佳阈值为3.37,敏感度44.9%,特异度90.1%,曲线下面积为0.685(95%CI:0.653~0.717,P<0.001)。在低EOS亚组中,NLR预测慢阻肺急性加重的最佳阈值为3.33,敏感度52.4%,特异度89.1%,AUC为0.705(95%CI:0.662~0.748,P<0.001)。PLR无法有效预测慢阻肺急性加重。结论在EOS较低的慢阻肺患者中,NLR、PLR水平升高,NLR与肺功能有关,NLR对慢阻肺急性加重有一定预测效能。
Objective To investigate the differences in the neutrophil/lymphocyte ratio(NLR)and platelet/lympho‐cyte ratio(PLR)among chronic obstructive pulmonary disease(COPD)patients with different blood eosinophil(EOS) levels,and to explore its predictive efficacy for acute exacerbation of COPD patients with different EOS levels.Methods A total of 662 patients with acute exacerbation of COPD(AECOPD group)and 335 patients with stable COPD(stable group)were divided into subgroups,low(≤100/μL)EOS subgroup,medium(100/μL<EOS<300/μL)EOS subgroup,and high(≥300/μL)EOS subgroup according to their blood EOS levels.The differences of NLR and PLR in each group,and the correlation between NLR and PLR and lung function were compared.The predictive value of NLR and PLR in acute exacerbation of COPD was analyzed by receiver operating characteristic(ROC)curve.Results①In the AECO‐PD group,the NLRs of low,medium and high EOS subgroups were 3.42,2.86 and 2.34,respectively,and PLR were 129.07,115.03 and 107.96,respectively.The NLR and PLR of low EOS subgroup were higher than those of medium and high EOS subgroups(all P<0.05).In the stable group,the NLRs of low EOS subgroup,medium EOS subgroup and high EOS subgroup were 2.41,2.22 and 2.20,and the PLRs were 128.00,117.82 and 109.30,respectively.The NLR of low EOS subgroup was higher than those of medium EOS subgroup and high EOS subgroup,and the PLR of low EOS subgroup was higher than that of high EOS subgroup(all P<0.05).The median NLR was 3.09,which was higher than that of the stable group(2.29,P<0.05),but PLR had no significant difference.In the low and medium EOS sub‐groups,the NLR of the AECOPD group was higher than that of the stable group(P<0.05),but there was no significant dif‐ference between the high EOS subgroups.②In the low EOS subgroup,NLR was negatively correlated with FVC,FVC%,FEV1,FEV1%,and FEV1/FVC(all P<0.05).In the medium EOS subgroup,NLR was negatively correlated with FVC,FVC%,FEV1,FEV1%,and FEV1/FVC(all P<0.05),and PLR was negatively correlated with FEV1
作者
侯媛媛
曾晓丽
包海荣
刘晓菊
HOU Yuanyuan;ZENG Xiaoli;BAO Hairong;LIU Xiaoju(The First Clinical Medical College of Lanzhou University,Lanzhou 730000,China)
出处
《山东医药》
CAS
2022年第27期19-23,共5页
Shandong Medical Journal
基金
国家自然科学基金(81960009)。
