慢性阻塞性肺疾病急性加重患者外周血中性粒细胞/淋巴细胞比值、红细胞分布宽度的诊断价值及相关性分析

Diagnostic value and correlation analysis of peripheral blood neutrophil-to-lymphocyte ratio and red blood cell distribution width in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(简称慢阻肺)加重期患者外周血中性粒细胞/淋巴细胞比值(NLR)、红细胞分布宽度(RDW)的相关性及诊断价值。方法选取我院2019年1月至2020年10月期间,接受住院治疗的100例慢阻肺急性加重患者为加重组,同一时间接受治疗的慢性阻塞性肺疾病稳定期患者100例为稳定组。收集患者一般资料,采集患者血液标本检测血红蛋白(Hb)、血小板计数(PLT)、白细胞计数(WBC)、中性粒细胞计数、淋巴细胞计数、RDW,计算NLR,分析各检测指标间的相关性,并绘制受试者特征工作曲线(ROC曲线)分析相关指标检测意义。结果加重组患者Hb、PLT水平与稳定组比较差异无统计学意义(均P>0.05);加重组患者的WBC、NLR、RDW以及hs-CRP水平,相比较于稳定组患者明显较高(均P<0.05);慢阻肺急性加重患者NLR与患者血清学指标WBC、hs-CRP存在正相关性(均P<0.05);ROC曲线显示,诊断慢阻肺急性加重时,NLR的特异性最高,为92.0%,RDW的敏感性最高,为91.0%,NLR+RDW的敏感性和特异性分别为90.0%和73.0%,诊断效能最好。结论慢阻肺急性加重患者的外周血中WBC、hs-CRP、NLR以及RDW异常升高,且NLR与WBC、hs-CRP具有正相关性,NLR和RDW在慢阻肺加重期患者的诊断中,分别具有较高的特异性和敏感性,可作为临床诊断与评估的简易指标。

Objective To explore the correlation and diagnostic value of neutrophil-to-lymphocyte ratio(NLR) and red blood cell distribution width(RDW) in peripheral blood of patients with exacerbation of chronic obstructive pulmonary disease(COPD). Methods One hundred patients with acute exacerbation of COPD who were hospitalized in the hospital between January 2019 and October 2020 were selected as exacerbation group, and another 100 patients with stable COPD who received treatment during the same time period were enrolled as stable group. The general data of patients were collected, and blood samples were collected to detect hemoglobin(Hb), platelet count(PLT), white blood cell count(WBC), neutrophil count, lymphocyte count and RDW, and the NLR was calculated. The correlation between the detection indicators was analyzed and receiver operating characteristic(ROC) curve was drawn to analyze the detection significance of related indicators. Results There were no statistical differences in the levels of Hb and PLT between the exacerbation group and the stable group(P>0.05). The levels of WBC, NLR, RDW and high-sensitivity C-reactive protein(hs-CRP) in the exacerbation group were significantly higher than those in the stable group(all P<0.05). NLR in the patients with acute exacerbation of COPD was positively correlated with serological indicators of WBC and hs-CRP(all P<0.05). ROC curve showed that the sensitivity and specificity of NLR in the diagnosis of acute exacerbation of COPD were 92.0% and 68.0% respectively, those of RDW were 91.0% and 58.0% respectively, those of hs-CRP were 77.0% and 71.0% respectively, and those of NLR+RDW were 90.0% and 73.0% respectively. NLR had the highest diagnostic specificity, RDW had the highest diagnostic sensitivity, and NLR+RDW had the best diagnostic efficiency.Conclusions Serological indicators of WBC, hs-CRP, NLR and RDW in patients with acute exacerbation of COPD will be abnormally increased, and NLR has a positive correlation with WBC and hs-CRP. NLR and RDW have high specificity and high sensitivity respectively in the diagnosis of patients with exacerbation of COPD, and their detection can strengthen the diagnosis and mastery of disease in patients.