Servicio de Neumología e Instituto de Investigación La Fe (IISLAFE), Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, 28220 Madrid, Spain.
Biomolecules. 2022 Sep 30;12(10):1399. doi: 10.3390/biom12101399.
Most patients with bronchiectasis have a predominantly neutrophilic inflammatory profile, although other cells such as lymphocytes (as controllers of bronchial inflammation) and eosinophils also play a significant pathophysiological role. Easy-to-interpret blood biomarkers with a discriminative capacity for severity or prognosis are needed. The objective of this study was to assess whether the peripheral neutrophil-to-lymphocyte ratio (NLR) is associated with different outcomes of severity in bronchiectasis. A total of 1369 patients with bronchiectasis from the Spanish Registry of Bronchiectasis were included. To compare groups, the sample was divided into increasing quartiles of NLR ratio. Correlations between quantitative variables were established using Pearson's P test. A simple linear regression (with the value of exacerbations as a quantitative variable) was used to determine the independent relationship between the number and severity of exacerbations and the NLR ratio. The area under the curve (AUC)-ROC was used to determine the predictive capacity of the NLR for severe bronchiectasis, according to the different multidimensional scores. Mean age: 69 (15) years (66.3% of women). The mean NLR was 2.92 (2.03). A higher NLR was associated with more severe bronchiectasis (with an especially significant discriminative power for severe forms) according to the commonly used scores (FACED, E-FACED and BSI), as well as with poorer quality of life (SGRQ), more comorbidities (Charlson index), infection by pathogenic microorganisms, and greater application of treatment. Furthermore, the NLR correlated better with severity scores than other parameters of systemic inflammation. Finally, it was an independent predictor of the incident number and severity of exacerbations. In conclusion, the NLR is an inexpensive and easy-to-measure marker of systemic inflammation for determining severity and predicting exacerbations (especially the most severe) in patients with bronchiectasis.
大多数支气管扩张症患者具有以中性粒细胞为主的炎症特征，尽管淋巴细胞（作为支气管炎症的控制器）和嗜酸性粒细胞等其他细胞也发挥着重要的病理生理作用。需要易于解释且具有区分严重程度或预后能力的血液生物标志物。本研究旨在评估外周血中性粒细胞与淋巴细胞比值（NLR）是否与支气管扩张症的严重程度的不同结局相关。共纳入来自西班牙支气管扩张症登记处的 1369 例支气管扩张症患者。为了比较组间差异，将样本分为 NLR 比值递增四分位数。使用 Pearson P 检验建立定量变量之间的相关性。使用简单线性回归（以加重次数作为定量变量）来确定 NLR 比值与加重次数和严重程度之间的独立关系。使用曲线下面积（AUC）-ROC 来确定 NLR 对严重支气管扩张症的预测能力，根据不同的多维评分。平均年龄：69（15）岁（66.3%为女性）。平均 NLR 为 2.92（2.03）。更高的 NLR 与更严重的支气管扩张症相关（根据常用评分[FACED、E-FACED 和 BSI]具有特别显著的鉴别能力），与较差的生活质量（SGRQ）、更多的合并症（Charlson 指数）、致病微生物感染以及更多的治疗应用相关。此外，NLR 与严重程度评分的相关性优于其他全身炎症参数。最后，它是预测支气管扩张症患者加重次数和严重程度的独立指标。总之，NLR 是一种廉价且易于测量的全身炎症标志物，可用于确定严重程度和预测加重（尤其是最严重的）。
