Department of Lab Sciences, Command Hospital, Kolkata, West Bengal, India.
School of Public Health, Kalinga Institute of Industrial Technology University, Bhubaneswar, Odisha, India.
Int J Lab Hematol. 2024 Aug;46(4):627-636. doi: 10.1111/ijlh.14264. Epub 2024 Mar 15.
Diagnosis of asthma and chronic obstructive pulmonary disease (COPD) becomes difficult in a primary healthcare center due to ambiguous interpretation of spirometry and lack of facility to access established biomarkers. While routine hematological indices are easily available and accessible. The study aimed to evaluate the role of different hemogram indexes in males in COPD, asthma, and healthy smokers.
Lung function tests and complete blood count (CBC) were done for 50 male subjects each from asthma, COPD, and healthy smokers. Multivariate analysis (MVA) was performed on blood indices data set. Receiver operating characteristic (ROC) curve was plotted to observe the performance of indexes. Pearson correlation was used to establish association between the lung function and blood indices.
Most of the indices were elevated in COPD. Whereas, asthma patients showed a significant increase in eosinophil basophil ratio (EBR), lymphocyte-monocyte ratio (LMR), and mean platelet volume-platelet count ratio (MPR). Orthogonal (O)- Partial Least-Squares Discriminant Analysis (PLSDA) and variable importance in projection (VIP) score established EBR, neutrophil-lymphocyte ratio (NLR) and LMR, as discriminants for asthma. Whereas, Systemic Inflammatory Response Index (SIRI), NLR and EBR were the key variables for COPD. NLR (r = -0.73, p < 0.001) and SIRI (r = -0.71, p < 0.001) were found to be negatively correlated with forced expiratory volume in 1 s (FEV1) percentage of the predicted value (%pred) in asthma and COPD, respectively. EBR showed the sensitivity and specificity of 96% and 86% respectively in asthma. NLR was having sensitivity of 82% and 90% specificity in COPD.
Our study in males shows routine hematological indices as being cost-effective, feasible, and seem to have tremendous potential as screening markers among chronic respiratory diseases in a primary healthcare center.
由于对肺功能测定的解读不明确以及缺乏既定生物标志物的检测条件,初级保健中心在哮喘和慢性阻塞性肺疾病(COPD)的诊断变得较为困难。而常规血液学指标则易于获取。本研究旨在评估不同的男性血液学指标在 COPD、哮喘和健康吸烟者中的作用。
对 50 名哮喘、COPD 和健康吸烟者的男性进行肺功能检查和全血细胞计数(CBC)。对血液指标数据集进行多元分析(MVA)。绘制接受者操作特征(ROC)曲线以观察指标的性能。使用 Pearson 相关性建立肺功能与血液指标之间的关联。
大多数指标在 COPD 中升高。而哮喘患者的嗜酸性粒细胞/嗜碱性粒细胞比值(EBR)、淋巴细胞/单核细胞比值(LMR)和平均血小板体积/血小板计数比值(MPR)显著增加。正交(O)-偏最小二乘判别分析(PLSDA)和变量重要性投影(VIP)得分确定 EBR、中性粒细胞/淋巴细胞比值(NLR)和 LMR 是哮喘的判别因素。而全身炎症反应指数(SIRI)、NLR 和 EBR 是 COPD 的关键变量。NLR(r=-0.73,p<0.001)和 SIRI(r=-0.71,p<0.001)与哮喘和 COPD 中用力呼气量 1 秒(FEV1)占预计值的百分比(%pred)呈负相关。EBR 在哮喘中的敏感性和特异性分别为 96%和 86%。NLR 在 COPD 中具有 82%的敏感性和 90%的特异性。
我们的男性研究表明,常规血液学指标具有成本效益、可行性,并且似乎在初级保健中心的慢性呼吸道疾病中具有作为筛查标志物的巨大潜力。