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.
Int J Immunopathol Pharmacol. 2021 Jan-Dec;35:20587384211040641. doi: 10.1177/20587384211040641.
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.
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.
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.
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.
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。
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。
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。
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。
