慢性阻塞性肺疾病患者红细胞分布宽度、中性粒细胞与淋巴细胞比值及预后的相关性分析

Correlation analysis of red blood cell distribution,neutrophil-to-lymphocyte ratio and prognosis in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)的变化,探讨其作为COPD患者预后判断检测指标的价值。方法收集2016年9月至2017年6月该院收治的138例COPD患者,随访患者一年后的生存或死亡情况,并将其分为生存组和死亡组。分析COPD患者基线RDW、NLR和PLR,采用Cox回归分析探讨RDW、NLR和PLR与患者预后的关系,采用Kaplan-Meier生存曲线分析不同RDW、NLR和PLR COPD患者间的预后差异。结果生存组的基线RDW、NLR、心肌肌钙蛋白T(cTNT)、氨基末端B型尿钠肽前体(NT-proBNP)和高敏C反应蛋白(hs-CRP)水平明显低于死亡组,差异均有统计学意义(P<0.05)。多因素分析结果显示,排除其他各因素影响后,RDW、NLR和PLR仍是决定COPD患者预后的潜在危险因素。RDW、NLR和PLR的中位数值分别为14.45%、6.15、187.68,Kaplan-Meier生存曲线分析结果显示,RDW<14.45%组预后生存明显优于RDW≥14.45%组(P<0.001);NLR<6.15组预后生存明显优于NLR≥6.15组(P<0.001);PLR<187.68组与PLR≥187.68组预后生存比较,差异无统计学意义(P>0.05)。结论COPD患者RDW和NLR升高与其死亡风险的增加密切相关,RDW和NLR可作为COPD患者预后判断的潜在指标。

Objective To explore changes of red cell distribution width(RDW),neutrophil-to-lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in chronic obstructive pulmonary disease(COPD)patients,and evaluate their value as the prognosis index in COPD patients.Methods A total of 138 patients with COPD were collected from September 2016 to June 2017,patients were followed up for the survival or death situation after one year,and were divided into survival group and death group.Baseline RDW,NLR and PLR values in COPD patients were analyzed,Cox regression analysis was used to explore the relationship of RDW,NLR and PLR with the prognosis of patients,and the Kaplan-Meier survival curve was used to analyze the difference of prognosis in COPD patients with different values of RDW,NLR and PLR.Results The baseline RDW,NLR,cardiac troponin T(cTNT),N terminal pro B type natriuretic peptide(NT-proBNP)and hypersensitive-CRP(hs-CRP)of COPD patients in the survival group were significantly lower than those in the death group,and the differences were statistically significant(P<0.05).Multivariate analysis showed that after excluding other factors,RDW,NLR and PLR were still potential risk factors for the prognosis of COPD patients.The median values of RDW,NLR and PLR were 14.45%,6.15 and 187.68 respectively,the COPD patients were divided into≥median array group and<median array group,and Kaplan Meier survival curve was analyzed.The results showed that the prognosis of RDW<14.45%group was significantly better than that of RDW≥14.45%group(P<0.001),the prognosis of NLR<6.15 group was better than that of NLR≥6.15 group(P<0.001),and there was no significant difference between PLR<187.68 group and PLR≥187.68 group(P>0.05).Conclusion The increase of RDW and NLR in COPD patients closely related to the increased risk of death.RDW and NLR can be used as potential prognostic indicators for COPD patients.