NLR、AGR在急性哮喘重度发作中的预测价值

Predictive Value of NLR and AGR in the Severe Asthma Acute Exacerbation

目的 探讨中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)与白蛋白与球蛋白比值(albumin-globulin ratio,AGR)在急性哮喘重度发作中的预测价值。方法 回顾性分析于徐州医科大学附属医院就诊的211例哮喘患者的临床资料,根据哮喘急性发作时病情严重程度分级将其分为轻度、中度和重度组,分别为65、98和48例。比较3组间中性粒细胞绝对值(neutrophil,Neu)、淋巴细胞绝对值(lymphocyte,Lym)、白蛋白(albumin,ALB)、球蛋白(globulin,GLB)、NLR、AGR的差异,以受试者工作特征曲线(ROC曲线)评价各指标对急性哮喘重度发作的预测价值。结果 各组间Neu、Lym、ALB、GLB、NLR、AGR比较,差异有统计学意义(P<0.05)。Neu、Lym、NLR、ALB、GLB、AGR预测急性哮喘重度发作的曲线下面积(AUC)分别为0.749、0.627、0.757、0.715、0.687和0.748(P<0.05)。其中NLR预测急性哮喘重度发作的最佳临界值为4.715,敏感度为60.4%,特异性为84.0%。AGR预测急性哮喘重度发作的最佳临界值为1.565,敏感度为62.0%,特异性为79.2%。结论 支气管哮喘急性发作患者外周血NLR升高,AGR降低,对评估哮喘病情严重程度有一定的临床指导意义。

Objective To investigate the predictive value of neutrophil-lymphocyte ratio(NLR) and albumin-globulin ratio(AGR) in the severe asthma exacerbation.Methods The clinical data of 211 patients with asthma who visited the Affiliated Hospital of Xuzhou Medical University were analyzed retrospectively.And they were divided into mild,moderate and severe groups(65 cases,98 cases and 48 cases,respectively) according to the severity of asthma exacerbations.The differences of inflammatory indexes(Neu,Lym,ALB,GLB,NLR,AGR)among the three groups were compared,and the predictive value of each index for severe attack of acute asthma was evaluated by the receiver-operating characteristic(ROC) curve.Results There were significant differences in the above inflammatory indexes among the 3 groups(P<0.05).The areas under the curve of Neu,Lym,NLR,ALB,GLB and AGR for the predictive value of severe asthma exacerbation were 0.749,0.627,0.757,0.715,0.687,0.748(P<0.05).The optional cut-off value of NLR was 4.715,the sensitivity was 60.4% and the specificity was 84.0%.While the optional cut-off value of AGR was 1.565,the sensitivity was 62.0% and the specificity of 79.2%.Conclusion NLR increased and AGR decreased in peripheral blood of patients with acute bronchial asthma,which has certain clinical guiding significance for assessing the severity of asthma.