慢性阻塞性肺疾病患者血清中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、降钙素原水平与急性加重风险的相关性研究

The correlation between the NLR,PLR and serum PCT and the acute exacerbation risk in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者血清中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、降钙素原(PCT)表达水平与急性加重风险的相关性。方法选取2018年1月至2020年1月我院收治的COPD患者252例,按照病情严重程度分为151例COPD急性加重期(AECOPD)组与101例稳定期(SCOPD)组,并选取同时期健康体检者150例为对照组。检测三组血清NLR、PLR、PCT水平,分析血清NLR、PLR、PCT水平预测COPD急性加重风险的价值及相关性。结果AECOPD组与SCOPD组血清NLR、PLR、PCT水平均高于对照组,且AECOPD组高于SCOPD组(P<0.05);ROC曲线分析显示,NLR敏感度与特异度分别为84.8%、84.2%,PLR敏感度与特异度分别为81.5%、82.2%,PCT敏感度与特异度分别为91.4%、91.1%;Ⅳ级患者血清NLR、PLR、PCT水平高于Ⅲ级、Ⅱ级和Ⅰ级患者(P<0.05);COPD患者血清NLR、PLR水平与PCT呈正相关(P<0.05)。结论COPD患者血清NLR、PLR、PCT水平明显升高,患者急性加重风险与血清NLR、PLR、PCT水平异常关系密切。

Objective To explore the correlation between the neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and serum procalcitonin level(PCT)and the acute exacerbation risk in patients with chronic obstructive pulmonary disease(COPD).Methods We selected 252 patients with COPD admitted to our hospital between January 2018 and January 2020.The patients were divided into an acute exacerbation of COPD(AECOPD)group(n=151)and a stable COPD(SCOPD)group(n=101)according to the severity of COPD.Meanwhile,150 healthy individuals were selected as a control group.The three groups of serum NLR,PLR and PCT levels were detected.The correlation between the NLR,PLR and PCT levels and the AECOPD was analyzed.Results The serum levels of NLR,PLR and PCT in the AECOPD group and the SCOPD group were higher than those in the control group,and those in the AECOPD group were higher than those in the SCOPD group(P<0.05).ROC curve analysis showed that the sensitivity and specificity of NLR were 84.8%and 84.2%,PLR were 81.5%and 82.2%,and PCT were 91.4%and 91.1%.Serum NLR,PLR and PCT levels in patients with grade IV were higher than those of patients with gradeⅢ,gradeⅡand gradeⅠ(P<0.05).Pearson correlation analysis showed that serum NLR and PLR levels were positively correlated with serum PCT level in patients with COPD(P<0.05).Conclusion Patients with COPD have significantly elevated serum NLR,PLR and PCT levels.The acute exacerbation risk is closely related to the levels of NLR,PLR and PCT.