Furutate Ryuko, Ishii Takeo, Motegi Takashi, Hattori Kumiko, Kusunoki Yuji, Gemma Akihiko, Kida Kozui
Respiratory Care Clinic, Nippon Medical School, Japan.
Intern Med. 2016;55(3):223-9. doi: 10.2169/internalmedicine.55.5772. Epub 2016 Feb 1.
Objective Although chronic obstructive pulmonary disease (COPD) is characterized by systemic inflammation, the association between the neutrophil to lymphocyte ratio (NLR; an indicator of inflammation) and the clinical status of COPD has not been well studied. We hypothesized that the NLR is associated with disease severity and exacerbation in COPD patients. Methods We performed blood testing, pulmonary function testing, chest computed tomography, a body composition analysis, and a 6-minute walk test and applied the modified Medical Research Council (MMRC) dyspnea scale for 141 stable COPD patients. In addition, we calculated the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index to evaluate the disease severity. Finally, we examined the association between the NLR and clinical parameters in stable COPD patients, and we further investigated changes in the NLR between exacerbation and the stable state. Results The NLR was positively correlated with the BODE index, extent of emphysema, and MMRC score (p<0.001 for all), while inversely correlated with airflow obstruction (p<0.001), body mass index (p<0.001), fat-free mass index (p=0.001), and the 6-minute walk distance (p<0.001). We obtained the NLR during exacerbation from 49 patients. The NLR was significantly higher at exacerbation compared to the stable state (p<0.001). Conclusion The NLR was associated with disease severity and exacerbation in COPD patients. Therefore, the usefulness of the NLR in COPD patients should be elucidated in clinical settings in future investigations.
目的 尽管慢性阻塞性肺疾病（COPD）以全身炎症为特征，但中性粒细胞与淋巴细胞比值（NLR，一种炎症指标）与COPD临床状态之间的关联尚未得到充分研究。我们假设NLR与COPD患者的疾病严重程度和急性加重相关。方法 我们对141例稳定期COPD患者进行了血液检测、肺功能检测、胸部计算机断层扫描、身体成分分析和6分钟步行试验，并应用改良的医学研究委员会（MMRC）呼吸困难量表。此外，我们计算了体重指数、气流阻塞、呼吸困难和运动能力（BODE）指数以评估疾病严重程度。最后，我们研究了稳定期COPD患者中NLR与临床参数之间的关联，并进一步调查了急性加重期与稳定期之间NLR的变化。结果 NLR与BODE指数、肺气肿程度和MMRC评分呈正相关（均p<0.001），而与气流阻塞（p<0.001）、体重指数（p<0.001）、去脂体重指数（p=0.001）和6分钟步行距离（p<0.001）呈负相关。我们从49例患者中获取了急性加重期的NLR。与稳定期相比，急性加重期的NLR显著更高（p<0.001）。结论 NLR与COPD患者的疾病严重程度和急性加重相关。因此，未来研究应在临床环境中阐明NLR在COPD患者中的实用性。
