中性粒细胞与淋巴细胞比值与哮喘严重程度的关系

Association between Neutrophil-lymphocyte Ratio and Asthma Severity

为研究外周血中性粒细胞与淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与哮喘严重程度的关系,收集2016年10月~2017年9月在徐州医科大学附属医院确诊的成人慢性持续期哮喘患者135例,将其分为轻、中和重度3组,其中轻度组41人,中度组46人,重度组48人。分别测定1 s用力呼气容积(forced expiratory volume in 1 second,FEV1)、FEV1占预计值百分比(FEV1 percentage of predicted,FEV1%pred)、用力肺活量(forced vital capacity,FVC)及FEV1/FVC,检测血常规、C反应蛋白(C-reactive protein,CRP),记录哮喘控制测试(asthma control test,ACT)评分。结果表明轻、中、重度组NLR水平呈依次升高,3组间存在统计学差异(P<0.05)。NLR与哮喘患者FEV1%pred呈负相关(r=-0.478,P<0.05),NLR与ACT评分呈负相关(r=-0.64,P<0.05),NLR与CRP呈正相关(r=0.361,P<0.05)。NLR、中性粒细胞计数、嗜酸粒细胞计数、淋巴细胞计数、CRP对重症哮喘诊断的曲线下面积分别为0.709、0.666、0.584、0.667(均P<0.05),NLR诊断重症哮喘的最佳临界值为6.79,敏感性45.59%,特异性96.35%。可见血清NLR与成人哮喘临床严重程度相关,检测NLR水平对判断哮喘临床严重程度可能有一定的价值。

In order to explore the association between the neutrophil/lymphocyte ratio(CN LR)and asthma severity.135 patients with chronic persistent asthma from the Affiliated Hospital of Xuzhou Medical University from October 2016 to September 2017 were recruited.The asthma patients were divided into mild,moderate and severe groups according to the severity of asthma.The forced expiratory volume in l second(FEV1),FEV1 percentage of predicted(FEV1%pred),forced vital capacity(FVC),and FEV1/FVC ratio,blood routine,C-reactive protein(CRP)were determined,asthma control test(ACT)scores were calculated.The results show that NLR levels were increased successively in mild,moderate and severe asthma groups,and NLR level in severe asthma group was significantly higher than those in mild to moderate asthma group(P<0.05).NLR levels are inversely associated with FEV1%(r=-0.478,P<0.05)and ACT scores(r=-0.640,P<0.05).The level of NLR is positively correlated with CRP(r=0.361,P<0.05).The areas under the curve of NLR,absolute neutrophil count,absolute eosinophil count,absolute lymphocyte count,CRP for the diagnosis of severe asthma are 0.709,0.666,0.584,0.667 respectively(all P<0.05);the optimal cut-off value of NLR is 6.79 for the diagnosis with a sensitivity of 45.59%and a specificity of 96.35%.It is concluded that NLR levels is correlated with clinical severity of adult asthma.It is valuable for adults with asthma to measure the NLR to predicting its clinical severity.