血小板/淋巴细胞比值预测慢性阻塞性肺疾病急性加重期伴有早期肾功能损害临床价值

Clinical value of platelet/lymphocyte ratio in predicting early renal impairment in acute exacerbation of chronic obstructive pulmonary disease

目的:探讨血小板/淋巴细胞比值(PLR)预测慢性阻塞性肺疾病急性加重期(AECOPD)伴有早期肾功能损害的临床价值。方法:选取220例AECOPD患者为研究对象,按照是否存在早期肾功能损害分为早期肾功能损害组[估测肾小球滤过率(eGFR)<90ml/[(min·1.73m2)]和肾功能正常组[eGFR≥90ml/[(min·1.73m2)]。比较两组一般临床资料的差异。结果:早期肾功能损害组糖尿病比例高于肾功能正常组,PaCO2、D-二聚体、FPG、hs-CRP、PLT、PLR高于肾功能正常组、LYM低于肾功能正常组,差异具有统计学意义(P<0.05)。Pearson相关分析显示,eGFR与PaCO2、D-二聚体、FPG、hs-CRP、PLT、PLR呈正相关(P<0.05),而与LYM呈负相关(P<0.05)。Logistic回归方程分析显示PLR是AECOPD伴有早期肾功能损害的独立危险因素。ROC曲线显示PLR预测此类患者早期肾功能损害的曲线下面积为0.838,敏感度为85.41%,特异度76.28%,最佳诊断截点为124.38。结论:PLR水平增高可能是AECOPD患者发生早期肾功能损害的独立预测因素,可作为评估此类患者预后的参考指标之一。

Objective:To investigate the clinical value of platelet/lymphocyte ratio(PLR)in predicting early renal impairment in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:220 patients with AECOPD were selected as study subjects.According to early renal impairment,they were divided into early renal impairment group[eGFR<90ml/(min 1.73m2)]and normal renal function group[eGFR 90ml/(min 1.73m2)].The difference of general clinical data between the two groups was compared.Results:The proportion of diabetes mellitus in early renal impairment group was higher than normal renal function group.PaCO 2,D-dimer,FPG,hs-CRP,PLT,PLR were higher than normal group and LYM were lower than normal renal function group.The difference was statistically significant.Meaning(P<0.05).Pearson correlation analysis showed that eGFR was positively correlated with PaCO 2,D-dimer,FPG,hs-CRP,PLT and PLR(P<0.05),but negatively correlated with LYM(P<0.05).Logistic regression analysis showed that PLR was an independent risk factor for AECOPD with early renal impairment.ROC curve showed that the area under curve of PLR predicting early renal impairment was 0.838,the sensitivity was 85.41%,the specificity was 76.28%,and the best diagnostic cut-off point was 124.38.Conclusion:Increased PLR level may be an independent predictor of early renal impairment in AECOPD patients,and can be used as one of the prognostic indicators for such patients.