Navodaya Medical College and Research Institute, Raichur.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
COPD is currently the fourth leading cause of death the world but is projected to be 3rd leading cause of death by 2020. It is characterized by limitation of airflow which is not fully transformable to normal along with increased long term inflammatory response in airways of the tracts of lungs. Acute exacerbations of COPD (AECOPD) are the most common causes of hospitalization and death among COPD patients. CRP, leukocytes, IL-6, IL-8 and fibrinogen are associated with COPD. However, while these biomarkers may be helpful, many of them are time consuming with extra cost, and some of the tests are not readily clinically available. Neutrophil-to-Lymphocyte Ratio (NLR) and platelet lymphocyte ratio (PLR) are effortless and basic parameters that are readily obtained from the simplest and easily obtainable complete blood count, even in peripheral hospitals. Material: Study was conducted at NMCH &RC, Raichur, patients attending NMCH for a duration of 18 months. 100 patients with a confirmed diagnosis of COPD confirmed with pulmonary function test according to GOLD criteria were included in the study. Observation: Mean age of the study population was 67.14±8.03 years. Males were predominant with male to female ratio as 9:1.Mean NLR of the AECOPD patients from stage 1 was 3.73±0.18, stage 2 was 6.07±1.27, stage 3 was 6.02±1.14 and stage 4 was 8.19±2.66. When we compared the mean NLR of the patients between different stages of COPD, the difference was found to be statistically significant (p<0.05). It means mean NLR was higher in stage 4 as compared to other groups. Mean PLR of the AECOPD patients from stage 1 was 12690.48±3978.45, stage 2 was 22219.93±7797.9, stage 3 was 19158.73±5070.88 and stage 4 was 19544.87±10207.59. When we compared the mean PLR of the patients between different stages of COPD, the difference was found to be statistically significant (p<0.05). It means mean PLR was higher in stage 2 followed by stage 4 as compared to other groups Conclusion: The NLR and PLR may be used as a useful and easily accessible tool for evaluating the ongoing inflammation during stable period and the disease severity during acute exacerbations in COPD patients. NLR ratio is more specific to severity of COPD compared to PLR ratio.
COPD 目前是世界上第四大致死原因，但预计到 2020 年将成为第三大致死原因。它的特点是气流受限，这种受限不能完全转化为正常，同时肺部气道的长期炎症反应也会增加。COPD 的急性加重（AECOPD）是 COPD 患者住院和死亡的最常见原因。CRP、白细胞、IL-6、IL-8 和纤维蛋白原与 COPD 有关。然而，虽然这些生物标志物可能有帮助，但其中许多生物标志物既费时又费钱，而且有些测试在临床上不容易获得。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）是从最简单、最容易获得的全血细胞计数中获得的简单且基本的参数，即使在周边医院也是如此。材料：这项研究在 NMCH&RC 进行，Raichur，在 18 个月的时间里，有 100 名被确诊为 COPD 的患者在 NMCH 接受治疗。研究纳入了根据 GOLD 标准通过肺功能测试确诊为 COPD 的 100 名患者。观察：研究人群的平均年龄为 67.14±8.03 岁。男性占优势，男女比例为 9:1。AECOPD 患者从第 1 阶段的平均 NLR 为 3.73±0.18，第 2 阶段为 6.07±1.27，第 3 阶段为 6.02±1.14，第 4 阶段为 8.19±2.66。当我们比较 COPD 不同阶段患者的平均 NLR 时，发现差异具有统计学意义（p<0.05）。这意味着第 4 阶段的平均 NLR 高于其他阶段。AECOPD 患者从第 1 阶段的平均 PLR 为 12690.48±3978.45，第 2 阶段为 22219.93±7797.9，第 3 阶段为 19158.73±5070.88，第 4 阶段为 19544.87±10207.59。当我们比较 COPD 不同阶段患者的平均 PLR 时，发现差异具有统计学意义（p<0.05）。这意味着第 2 阶段和第 4 阶段的平均 PLR 高于其他阶段。结论：NLR 和 PLR 可作为 COPD 患者稳定期评估持续炎症和急性加重期疾病严重程度的有用且易于获取的工具。与 PLR 比值相比，NLR 比值对 COPD 的严重程度更具特异性。
