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Received:March 11, 2022 Published Online:September 20, 2022
Received:March 11, 2022 Published Online:September 20, 2022
中文摘要: 目的 探讨中性粒细胞/淋巴细胞比值(NLR)在急性加重期慢性阻塞性肺疾病(AECOPD)患者低氧血症诊断中的预测价值。方法 回顾性分析2020年1月至2021年12月安徽省第二人民医院呼吸内科收治确诊的AECOPD患者130例的临床资料和实验室指标结果,根据动脉血氧分压(PaO2)水平将130例患者分为低氧血症组70例(PaO2<83 mm Hg)和非低氧血症组60例(PaO2≥83 mm Hg)。检测两组患者静脉血白细胞计数(WBC)、中性粒细胞计数(N)、淋巴细胞计数(L)、单核细胞计数(M)、血小板(PLT)、红细胞分布宽度(RDW)、超敏C反应蛋白(hs-CRP)、白蛋白(ALB)及纤维蛋白原(FIB),计算中性粒细胞与淋巴细胞比值(NLR)。 采用ROC曲线评估hs-CRP、WBC、NLR、FIB在低氧血症诊断中的预测效能,采用logistic回归分析NLR与低氧血症之间的相关性。结果 低氧血症组的NLR显著高于非伴低氧血症组,(13.5±6.3 vs 3.9±1.7,P<0.01);NLR与AECOPD患者PaO2呈负相关(r=-0.549, P<0.01);预测低氧血症的ROC曲线中,NLR的AUC最大,其他依次为hs-CRP、WBC和FIB;NLR是AECOPD患者并发低氧血症的独立危险因素(OR=15.102,95%CI:3.137~72.688,P=0.001)。结论 NLR可能是预测AECOPD患者并发低氧血症的生物标志物。
中文关键词: 慢性阻塞性肺疾病,急性加重期 低氧血症 中性粒细胞与淋巴细胞比值
Abstract:Objective To investigate the clinical value of neutrophil/lymphocyte ratio (NLR) in predicting hypoxemia in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A retrospective analysis was performed on the clinical data and laboratory indicators of 130 patients with AECOPD treated in the Second People's Hospital of Anhui Province from January 2020 to December 2021. Based on the arterial partial pressure of oxygen (PaO2) level, the patients were divided into hypoxemia group (PaO2<83 mm Hg, n=70) and non-hypoxemia group (PaO2 ≥ 83 mm Hg, n=60). White blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), monocyte count (MC), platelet count (PLT), red blood cell distribution width (RDW), hypersensitive C-reactive protein (hs-CRP), albumin (ALB), and fibrinogen (FIB) were measured, and NLR was calculated in two groups. ROC curve was used to evaluate the predictive efficacy of hs-CRP, WBC, NLR and FIB in the diagnosis of hypoxemia. Logistic regression was used to analyze the correlation between NLR and hypoxemia. Results NLR in hypoxemia group was significantly higher than that in non-hypoxemia group (13.5±6.7 vs 3.9±1.7, P<0.01) and was negatively correlated with PaO2 level (r=-0.549, P<0.01). The AUC of NLR for predicting hypoxemia was the largest, followed by hs-CRP, WBC and FIB. Low NLR was an independent risk factor for hypoxemia in patients with AECOPD (OR=15.102,95%CI:3.137-72.688, P=0.001). Conclusion NLR can be a potential biomarker for predicting hypoxemia in patients with AECOPD.
keywords: Chronic obstructive pulmonary disease, acute exacerbation Hypoxemia Neutrophil to lymphocyte ratio
文章编号: 中图分类号:R563 文献标志码:B
基金项目:安徽省教育厅自然科学重点项目(KJ2019A1099)
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