C 反应蛋白水平与中性粒细胞/淋巴细胞比值联合评分：鉴别哮喘加重患儿的新型标志物。
Combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio: A novel marker in distinguishing children with exacerbated asthma.
机构信息
Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China.
Department of Respiratory Medicine, Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China.
出版信息
Int J Immunopathol Pharmacol. 2021 Jan-Dec;35:20587384211040641. doi: 10.1177/20587384211040641.
BACKGROUND
Both C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) are commonly elevated in patients with asthma. It is necessary to develop a novel marker, the combined score of CRP level and NLR (C-NLR score) based on cutoff points of CRP and NLR, and apply it in asthma diagnosis. The aim of this study was to explore whether C-NLR could distinguish children with exacerbated asthma.
METHODS
Children suffering from exacerbated asthma were regarded as the asthmatic group ( = 86), which was divided into three groups: mild ( = 54), moderate ( = 17), and severe ( = 15). The control group consisted of children without any allergic disease and infection ( = 38). To compare CRP level and NLR between the asthmatic group and control group, a receiver-operating characteristic curve was constructed to determine area under the curve (AUC) and optimal cutoff point. Thereafter, the C-NLR score was classified as follows: C-NLR score of 2 with an elevated CRP level and high NLR, a C-NLR score of 1 with one of these abnormalities, and a C-NLR score of 0 with a normal CRP level and low NLR. The C-NLR score was then compared among different asthma groups.
RESULTS
In the control group, the CRP level and NLR were 1.9 (0.5-2.6) mg/L and 1.01 (0.69-1.31), respectively. In the asthmatic group, the CRP level and NLR were 7.3 (3.2-14.2) mg/L and 3.08 (1.73-5.34), respectively, which were higher than those in the control group ( < 0.001 for CRP and < 0.001 for NLR). The AUC of CRP was 0.86, and the optimal cutoff point was 3.6 mg/L. The AUC of NLR was 0.86, and the optimal cutoff point was 1.72. The AUC of the C-NLR score was 0.94, and the optimal cutoff point was 1.
CONCLUSIONS
C-NLR, a novel inflammatory marker, was applied here for the exacerbated asthma for the first time. Our study has shown C-NLR is a promising marker to distinguish children with exacerbated asthma from healthy children.
背景
C 反应蛋白（CRP）水平和中性粒细胞与淋巴细胞比值（NLR）在哮喘患者中通常升高。有必要基于 CRP 和 NLR 的截断值开发一种新的标志物，即 CRP 水平和 NLR 的联合评分（C-NLR 评分），并将其应用于哮喘的诊断。本研究旨在探讨 C-NLR 是否能区分加重的哮喘患儿。
方法
将患有加重性哮喘的患儿视为哮喘组（n=86），并将其分为三组：轻度（n=54）、中度（n=17）和重度（n=15）。对照组由无过敏疾病和感染的儿童组成（n=38）。为了比较哮喘组和对照组之间 CRP 水平和 NLR，构建了受试者工作特征曲线以确定曲线下面积（AUC）和最佳截断值。然后，将 C-NLR 评分分类如下：CRP 水平升高且 NLR 高的 C-NLR 评分 2，有一项异常的 C-NLR 评分 1，CRP 水平正常且 NLR 低的 C-NLR 评分 0。然后比较不同哮喘组之间的 C-NLR 评分。
结果
在对照组中，CRP 水平和 NLR 分别为 1.9（0.5-2.6）mg/L 和 1.01（0.69-1.31）。在哮喘组中，CRP 水平和 NLR 分别为 7.3（3.2-14.2）mg/L 和 3.08（1.73-5.34），均高于对照组（CRP < 0.001，NLR < 0.001）。CRP 的 AUC 为 0.86，最佳截断值为 3.6mg/L。NLR 的 AUC 为 0.86，最佳截断值为 1.72。C-NLR 评分的 AUC 为 0.94，最佳截断值为 1。
结论
C-NLR，一种新的炎症标志物，首次应用于加重性哮喘。我们的研究表明，C-NLR 是区分加重性哮喘患儿和健康儿童的一种有前途的标志物。
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