血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和嗜酸性粒细胞与淋巴细胞比值（ELR）作为慢性阻塞性肺疾病急性加重（AECOPD）患者的生物标志物。
Platelet-to-Lymphocyte Ratio (PLR), Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), and Eosinophil-to-Lymphocyte Ratio (ELR) as Biomarkers in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD).
机构信息
Department of Pharmacy, People's Hospital of Guilin, Guilin, People's Republic of China.
Department of Respiratory and Critical Care Medicine, People's Hospital of Guilin, Guilin, People's Republic of China.
出版信息
Int J Chron Obstruct Pulmon Dis. 2024 Feb 23;19:501-518. doi: 10.2147/COPD.S447519. eCollection 2024.
PURPOSE
The study comprehensively evaluated the prognostic roles of the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), basophil-to-lymphocyte ratio (BLR), and eosinophil-to-lymphocyte ratio (ELR) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
PATIENTS AND METHODS
Six hundred and nineteen patients with AECOPD and 300 healthy volunteers were retrospectively included into the study. The clinical characteristics of the patients with AECOPD and the complete blood counts (CBCs) of the healthy volunteers were collected. The associations of PLR, NLR, MLR, BLR, and ELR with airflow limitation, hospital length of stay (LOS), C-reactive protein (CRP), and in-hospital mortality in patients with AECOPD were analyzed.
RESULTS
Compared with the healthy volunteers, PLR, NLR, MLR, BLR, and ELR were all elevated in COPD patients under stable condition. PLR, NLR, MLR, and BLR were further elevated while ELR was lowered during exacerbation. In the patients with AECOPD, PLR, NLR, and MLR were positively correlated with hospital LOS as well as CRP. In contrast, ELR was negatively correlated with hospital LOS as well as CRP. Elevated PLR, NLR, and MLR were all associated with more severe airflow limitation in AECOPD. Elevated PLR, NLR, and MLR were all associated with increased in-hospital mortality while elevated ELR was associated with decreased in-hospital mortality. Binary logistic regression analysis showed that smoking history, FEV1% predicted, pneumonia, pulmonary heart disease (PHD), uric acid (UA), albumin, and MLR were significant independent predictors ofin-hospital mortality. These predictors along with ELR were used to construct a nomogram for predicting in-hospital mortality in AECOPD. The nomogram had a C-index of 0.850 (95% CI: 0.799-0.901), and the calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) further demonstrated its good predictive value and clinical applicability.
CONCLUSION
In summary, PLR, NLR, MLR, and ELR served as useful biomarkers in patients with AECOPD.
目的
本研究全面评估了血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、嗜碱性粒细胞与淋巴细胞比值（BLR）和嗜酸性粒细胞与淋巴细胞比值（ELR）在慢性阻塞性肺疾病急性加重（AECOPD）患者中的预后作用。
方法
回顾性纳入 619 例 AECOPD 患者和 300 名健康志愿者，收集 AECOPD 患者的临床特征和健康志愿者的全血细胞计数（CBC）。分析 PLR、NLR、MLR、BLR 和 ELR 与 AECOPD 患者气流受限、住院时间（LOS）、C 反应蛋白（CRP）和住院死亡率的关系。
结果
与健康志愿者相比，稳定期 COPD 患者的 PLR、NLR、MLR、BLR 和 ELR 均升高。在加重期间，PLR、NLR、MLR 和 BLR 进一步升高，而 ELR 降低。在 AECOPD 患者中，PLR、NLR 和 MLR 与 LOS 和 CRP 呈正相关。相反，ELR 与 LOS 和 CRP 呈负相关。升高的 PLR、NLR 和 MLR 均与 AECOPD 中更严重的气流受限相关。升高的 PLR、NLR 和 MLR 均与住院死亡率增加相关，而升高的 ELR 与住院死亡率降低相关。二元逻辑回归分析显示，吸烟史、FEV1%预测值、肺炎、肺心病（PHD）、尿酸（UA）、白蛋白和 MLR 是住院死亡率的显著独立预测因子。这些预测因子和 ELR 被用于构建 AECOPD 住院死亡率预测的列线图。该列线图的 C 指数为 0.850（95%CI：0.799-0.901），校准曲线、决策曲线分析（DCA）和临床影响曲线（CIC）进一步证明了其良好的预测价值和临床适用性。
结论
综上所述，PLR、NLR、MLR 和 ELR 可作为 AECOPD 患者有用的生物标志物。
Zotero 插件