Fang Li, Zhu Jianzhi, Fu Dandan
The Second Affiliated Hospital of ZunYi Medical University, Guizhou, China.
BMC Pulm Med. 2025 Apr 29;25(1):206. doi: 10.1186/s12890-025-03677-y.
Chronic obstructive pulmonary disease (COPD) involves inflammation as a key factor influencing its pathology and progression. This meta-analysis sought to assess the prognostic importance of the neutrophil-to-lymphocyte ratio (NLR) in individuals diagnosed with COPD.
Comprehensive searches were carried out in PubMed, Embase, Web of Science, and the Cochrane Library up to March 2025. All-cause mortality-related data were collected and analyzed. Outcomes were evaluated using odds ratios (ORs) and 95% confidence intervals (CIs).
Following a thorough review of the literature and a rigorous screening process, a total of 24 studies including 18,597 patients were selected for this meta-analysis. The cut-off range of NLR in all included literatures was 1.3 to 16.83. Analysis of categorical variables showed that COPD patients with elevated NLR levels faced a significantly higher all-cause mortality risk compared to those with lower NLR levels (OR: 1.03, 95% CI: 1.01-1.06, P = 0.009, I² = 89%). For continuous variables, deceased COPD patients exhibited significantly elevated NLR levels compared to survivors (SMD: 1.23, 95% CI: 0.90-1.57, P < 0.00001, I² = 97%). The subgroup analysis highlighted study design and the timing of NLR measurement as potential contributors to heterogeneity. Subgroup analysis showed that NLR had a better predictive value for disease in AECOPD subgroups.
This meta-analysis demonstrates a correlation between increased NLR levels and heightened all-cause mortality risk in COPD patients. Nevertheless, given the inherent limitations of this study, additional multi-center, prospective clinical trials are essential to confirm these findings.
慢性阻塞性肺疾病（COPD）涉及炎症，这是影响其病理和进展的关键因素。本荟萃分析旨在评估中性粒细胞与淋巴细胞比值（NLR）在COPD诊断个体中的预后重要性。
截至2025年3月，在PubMed、Embase、Web of Science和Cochrane图书馆进行了全面检索。收集并分析了全因死亡率相关数据。使用比值比（OR）和95%置信区间（CI）评估结果。
经过对文献的全面审查和严格筛选过程，本荟萃分析共纳入24项研究，涉及18597例患者。所有纳入文献中NLR的截断范围为1.3至16.83。分类变量分析表明，与NLR水平较低的COPD患者相比，NLR水平升高的患者全因死亡风险显著更高（OR：1.03，95%CI：1.01 - 1.06，P = 0.009，I² = 89%）。对于连续变量，与幸存者相比，死亡的COPD患者NLR水平显著升高（标准化均值差：1.23，95%CI：0.90 - 1.57，P < 0.00001，I² = 97%）。亚组分析强调研究设计和NLR测量时间是异质性的潜在因素。亚组分析表明，NLR在慢性阻塞性肺疾病急性加重（AECOPD）亚组中对疾病具有更好的预测价值。
本荟萃分析表明，COPD患者NLR水平升高与全因死亡风险增加之间存在相关性。然而，鉴于本研究的固有局限性，需要额外进行多中心、前瞻性临床试验来证实这些发现。
