外周血NLR在评估重度支气管哮喘急性发作期患者预后的中的意义

目的探讨外周血中性粒细胞与淋巴细胞比值（NLR）在评估重度支气管哮喘急性发作期患者预后中的意义。方法将185例重度支气管哮喘急性发作期患者按照住院期间预后情况分为死亡组（n=40例）和存活组（n=145例），比较两组一般临床资料，并利用Logistic回归方程分析NLR与患者预后的关系。结果与存活组比较，死亡组呼吸频率（RR）、心率（HR）较快（P均〈O．05），中性粒细胞计数、白细胞计数偏高，C反应蛋白（CRP），空腹血糖（FPG）、PaC02水平较高（P均〈0．05），而淋巴细胞计数、PaO2、SaO2、pH、FEV1、FEV1／FVC、PEF偏低（P均〈0．05），死亡组NLR水平（8．41±1．12）亦高于存活组（5．61±0．95）（t=15．140，P〈0．05）；NLR〉7．10组患者气管插管率、住院时闻、病死率均高于NLR≤7．10组（P均〈0．05）；Logistici回归方程显示，NLR分别是气管插管、住院时间（≥14d）、病死率的独立危险因素。结论NLR水平增高可能是重度支气管哮喘急性发作期患者不良预后的独立危险因素，临床早期检测NLR对于评估患者预后具有重要的指导意义。

Objective To investigate the significance of peripheral blood neutrophil to lymphocyte ratio （ NLR ） in evaluating the prognosis of patients with acute episodes of severe bronchial asthma. Methods 185 cases of patients with acute episodes of severe bronchial asthma were divided into death group （ n=40 cases ） and survival group （ n=145 cases ） based on prognosis during hospitalization. General clinical data were compared between the two groups. The relationship of NLR with prognosis used to analyze by Logistic regression equation analysis. Results Compared with survival group, death group was relate to be faster breathing rate （ RR ） and heart rate （ HR ） （ P〈0.05 ） , and higher neutrophil count, white blood ceU count, C-reactive protein （ CRP ） , fasting plasma glucose （ FPG ） , lower lymphocyte count, PaCO2, SaO2, pH, FEVI, FEV1/FVC and PEF （P〈0.05） . NLR level of death group （ 8.41 ± 1.12 ） was higher than survival group （P〈0.05） . Compared with NLR≤7.10 group, NLR〉7.10 group was related to be higher endotracheal intubation rate, death rate and longer hospital stays （P〈0.05） . Logistic regression equation showed that NLR was an independent risk factor of endotracheal intubation, hospitalization time （ greater than 14d ） and mortality. Conclusion NLR level may be an independent risk factor of patients with acute episodes of severe bronchial asthma. Early detection of NLR has an important guiding significance for evaluating patient＇ s prognosis.