中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值在慢性阻塞性肺疾病急性加重期的预后价值评估

Evaluation of the prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute exacerbation of chronic obstructive pulmonary disease.

作者信息

Emami Ardestani Mohammad, Alavi Naeini Nooshin

机构信息

Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2022 Jul 29;27:50. doi: 10.4103/jrms.JRMS_512_20. eCollection 2022.

DOI:10.4103/jrms.JRMS_512_20

PMID:36092488

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9450251/

Abstract

BACKGROUND

The present study aimed at determining and comparing the prognostic value and the relationship of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios (PLRs) with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

MATERIALS AND METHODS

The present case-control study was performed on 100 chronic obstructive pulmonary disease patients and 100 healthy subjects (controls). Age, gender, and laboratory results of complete blood count tests including lymphocyte count, neutrophil count, platelet count, hemoglobin level, neutrophil-to-lymphocyte ratio (NLR), PLR, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were obtained from the patient report and then recorded. The mentioned information was also completed for the control group. Following hospitalization, the patients that were discharged with clinically stable general status were re-examined, and the aforementioned laboratory information was rerecorded.

RESULTS

The results of the present study revealed that NLR with the sensitivity and specificity of 83.00% (74.2%-89.8%) and 93.00% (86.1%-97.1%) (cutoff value of 2.3), PLR with the sensitivity and specificity of 56.00% (46.0%-66.3%) and 83.00% (74.2%-89.8%) (cutoff value of 135.8), white blood cell (WBC) with the sensitivity and specificity of 69.00% (57.7%-77.8%) and 78.00% (68.6%-85.7%) (cutoff value of 8.5 × 103 μl), ESR with the sensitivity and specificity of 84.00% (75.3%-90.6%) and 99.00% (94.6%-100.0%) (cutoff value of 7.8), and CRP with the sensitivity and specificity of 52.00% (41.8%-62.1%) and 81.00% (71.9%-88.2%) (cutoff value of 1.9), respectively, had a significant prognostic value of AECOPD ( < 0.001). In addition to NLR had higher area under the curve (AUC) than PLR, WBC, and CRP. Therefore NLR had a better diagnostic value than the above three markers ( < 0.001). ESR also has higher AUC levels compared to PLR, WBC, and CRP and has a statistically better diagnostic value than them ( < 0.001), but did not differ significantly from ESR (difference between AUC: 0.02; = 0.059).

CONCLUSION

According to the results of the current study, NLR and PLR had a significant direct relationship with the two main markers of ESR and CRP, and both ratios had a significant prognostic value in AECOPD.

摘要

背景

本研究旨在确定并比较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）对慢性阻塞性肺疾病急性加重（AECOPD）的预后价值及其相互关系。

材料与方法

本病例对照研究纳入了100例慢性阻塞性肺疾病患者和100名健康受试者（对照组）。从患者报告中获取年龄、性别以及全血细胞计数检查的实验室结果，包括淋巴细胞计数、中性粒细胞计数、血小板计数、血红蛋白水平、NLR、PLR、C反应蛋白（CRP）和红细胞沉降率（ESR），并进行记录。对照组也完成上述信息的收集。患者住院后，对出院时一般状况临床稳定的患者进行复查，并重新记录上述实验室信息。

结果

本研究结果显示，NLR对AECOPD的敏感性和特异性分别为83.00%（74.2%-89.8%）和93.00%（86.1%-97.1%）（临界值为2.3），PLR的敏感性和特异性分别为56.00%（46.0%-66.3%）和83.00%（74.2%-89.8%）（临界值为135.8），白细胞（WBC）的敏感性和特异性分别为69.00%（57.7%-77.8%）和78.00%（68.6%-85.7%）（临界值为8.5×10³/μl），ESR的敏感性和特异性分别为84.00%（75.3%-90.6%）和99.00%（94.6%-100.0%）（临界值为7.8），CRP的敏感性和特异性分别为52.00%（41.8%-62.1%）和81.00%（71.9%-88.2%）（临界值为1.9），均对AECOPD具有显著的预后价值（P<0.001）。此外，NLR的曲线下面积（AUC）高于PLR、WBC和CRP。因此，NLR的诊断价值优于上述三种标志物（P<0.001）。ESR的AUC水平也高于PLR、WBC和CRP，其诊断价值在统计学上优于它们（P<0.001），但与NLR无显著差异（AUC差值：0.02；P=0.059）。