探讨NLR、LMR、PLR与慢性阻塞性肺疾病严重程度的相关性

To investigate the correlation of NLR,LMR,PLR with severity of Chronic Obstructive Pulmonary Disease

目的:研究中性粒细胞与淋巴细胞比值(neutrophil/lymphocyte ratio,NLR),淋巴细胞与单核细胞比值(lymphocyte/monocyte ratio,LMR),血小板与淋巴细胞比值(platelet/lymphocyte ratio,PLR)与慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)严重程度之间的关系。方法:随机选取2017年5月~2020年5月到芜湖市中医医院住院的慢性阻塞性肺疾病(COPD)患者,其中急性加重期(AECOPD组)140例,稳定期(COPD组)82例,并选取同一时间段在本院进行健康体检者117例为对照组。结果:与对照组相比,AECOPD组、COPD组NLR显著升高,且AECOPD组NLR显著高于COPD组,差异有统计学意义(P<0.05);AECOPD组LMR显著低于COPD组,两组LMR均显著低于对照组,差异有统计学意义(P<0.05);AECOPD组与COPD组的PLR均高于对照组,差异有统计学意义(P<0.05),但两组之间差异无统计学意义(P>0.05)。采用受试者工作特征曲线(ROC)分析,COPD急性期与非急性期(COPD组+对照组)比较,NLR、LMR、PLR的AUC为0.823,0.825,0.699,敏感性为75.7%,74.4%,65.0%,特异性为82.9%,80.0%,74.9%。三者联合的AUC为0.851,敏感性75.7%,特异性86.4%。COPD的阳性组(AECOPD组+COPD组)与阴性组(对照组)比较,NLR、LMR、PLR的AUC为0.876,0.918,0.770,敏感性为79.3%,96.6%,59%,特异性为86.3%,78.8%,91.5%。三者联合的AUC为0.926,敏感性为83.3%,特异性为91.5%。结论:NLR、LMR、PLR作为新型炎性指标,对COPD的严重程度具有一定的预测和诊疗价值,其三者联合效果更好。

Objective:To investigate the relationship among neutrophil/lymphocyte ratio(NLR),lymphocyte/monocyte ratio(LMR),platelet/lymphocyte ratio(PLR)and severity of chronic obstructive pulmonary disease(COPD).Methods:From May 2017 to May 2020,Patients with chronic obstructive pulmonary disease(COPD)who were hospitalized in Wuhu Traditional Chinese Medicine Hospital were enrolled,including 140 patients with the acute exacerbation stage(AECOPD group)and 82 patients with the stable stage(COPD group),and 117 healthy patients who underwent physical examination in our hospital during the same period were enrolled as the control group.Results:Compared with the control group,the NLR in AECOPD group and COPD group was significantly increased,and the NLR in AECOPD group was significantly higher than that in COPD group,the difference was statistically significant(P<0.05).LMR in AECOPD group was significantly lower than that in COPD group,and LMR in both groups was significantly lower than that in control group,with statistical significance(P<0.05).The PLR of AECOPD group and COPD group were higher than that of control group,the difference was statistically significant(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Using receiver Operating Characteristic(ROC)analysis,the AUC of NLR,LMR,and PLR was 0.823,0.825,0.699,the sensitivity was 75.7%,74.4%,65.0%,and the specificity was 82.9%,80.0%,74.9%in the acute phase of COPD compared with the non-acute phase(COPD group and control group).The AUC,sensitivity and specificity of the combination of three was 0.851,75.7%,86.4%.Comparison with the positive group of COPD(AECOPD group+COPD group)and the negative group(control group),the AUC of NLR,LMR and PLR were 0.876,0.918 and 0.770,the sensitivity was 79.3%,96.6%and 59%,and the specificity was 86.3%,78.8%and 91.5%.The AUC,sensitivity and specificity of the combination of the three was 0.926,83.3%,91.5%.Conclusion:The new inflammatory markers,NLR,LMR and PLR had prognostic and diagnostic value for the severity of patients with COPD,and the combination of the three was better.