MLR、RDW对AECOPD合并肺炎的早期预测价值研究

Research on the early predictive value of MLR and RDW in acute exacerbation of chronic obstructive pulmonary disease with pneumonia

目的探索单核细胞与淋巴细胞的比值(MLR)、红细胞体积分布宽度(RDW)对慢性阻塞性肺疾病急性加重(AECOPD)合并肺炎的早期预测价值。方法收集2019年6月~2020年1月我院收治的AECOPD患者332例,根据肺炎诊断标准分为合并肺炎组152例、非肺炎组180例。收集患者性别、年龄、住院时间、体质量指数(BMI)、血常规、红细胞沉降率(ESR)和基础疾病等资料。通过单因素分析及二元Logistics回归分析MLR、RDW对AECOPD合并肺炎的早期预测价值。通过绘制MLR、RDW及两者联合的受试者工作特征曲线(ROC),分析其评价AECOPD合并肺炎的预测效能,计算敏感度、特异度,获得MLR、RDW及两者联合的最佳截止点。结果肺炎组MLR明显高于非肺炎组,RDW低于非肺炎组,差异均有统计学意义(P<0.001)。二元Logistic回归分析显示MLR为AECOPD合并肺炎的独立危险因素(OR=21.898,95%CI:1.121~427.864,P<0.05),而RDW为其独立保护因素(OR=0.556,95%CI:0.446~0.692,P<0.05)。采用ROC曲线分析MLR、RDW及二者联合检测对AECOPD合并肺炎的预测价值,曲线下面积(AUC)分别为:0.731、0.734、0.784,灵敏度分别:66.4%、61.8%、67.8%,特异度分别:69.4%、83%、78.3%。结论MLR、RDW是AECOPD合并肺炎的独立预测因子。二者联合检测较单独检测对预测AECOPD合并肺炎的发生具有更好的效果。

Objective Discussing the early predictive value of monocyte-lymphocyte ratio(MLR)and red blood cell distribution width(RDW)in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with pneumonia.Methods 332 patients with AECOPD treated in our hospital from June 2019 to January 2020 were collected.According to the diagnostic criteria of pneumonia,they were divided into 152 cases in the pneumonia AECOPD group(pAECOPD)and 180 cases in the non-pneumonia group(npAECOPD).The gender,age,length of stay,BMI,blood routine,erythrocyte sedimentation rate(ESR)and underlying diseases were collected.Univariate analysis and binary logistic regression were utilized to look for the early predictive value of MLR and RDW for the AECOPD with pneumonia.By calculating the the receiver operating characteristic(ROC)curve of MLR,RDW and their combination,they were used to evaluate the predictive power of the AECOPD with pneumonia,and the sensitivity and specificity were calculated to obtain the best cut-off point of MLR,RDW and their combination.Results The MLR of pAECOPD group was higher than that of npAECOPD group(P<0.001),The RDW was significantly lower in pAECOPD group(P<0.001).After binary logistic regression analysis,MLR was regarded as an independent risk factor for patients with pAECOPD(OR=21.898,95%CI:1.121~427.864,P<0.05).However,the RDW is an independent protective factor(OR=0.556,95%CI:0.446~0.692,P<0.05).In the ROC curve,the area under the curve(AUC)of MLR,RDW and their combination were 0.731,0.734 and 0.784,the sensitivity were 66.4%,61.8%and 67.8%,the respectively and the specificity were 69.4%,83%and 78.3%.Conclusion MLR and RDW are independent predictors of patients with pAE-COPD.MLR combination with RDW play a better predictive role in the occurrence of pAECOPD than MLR and RDW.