NLR、PLR在慢性阻塞性肺疾病并发阻塞性睡眠呼吸暂停综合征中的临床意义

Clinical Significance of NLR and PLR in Chronic Obstructive Pulmonary Disease Complicated with Obstructive Sleep Apnea Syndrome

目的:探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)在慢性阻塞性肺疾病(COPD)-阻塞性睡眠呼吸暂停综合征(OSAS)重叠综合征的临床意义。方法:选取2020年6月-2022年6月玉林市第一人民医院收治的COPD患者90例为COPD组,COPD-OSAS重叠综合征患者46例为COPD-OSAS组,同期体检中心的健康体检者40例为对照组。比较三组间一般临床资料、血清中炎性指标水平。通过受试者工作特征曲线(ROC)评价NLR、PLR在COPD-OSAS重叠综合征患者诊断中的作用。结果:COPD组和COPD-OSAS组中性粒细胞计数(NEU)、血小板计数(PLT)、NLR、PLR均高于对照组,淋巴细胞计数(LYM)低于对照组,差异具有统计学意义(P<0.05);COPD-OSAS组NEU、NLR、PLR均高于COPD组,LYM低于COPD组,差异具有统计学意义(P<0.05);NLR诊断COPD-OSAS的AUC为0.916,敏感度为80.40%,特异度为84.60%,截断值为3.175;PLR诊断的AUC为0.667,敏感度为50.00%,特异度为83.80%,截断值为189.220。结论:血清NLR、PLR水平与COPD-OSAS重叠综合征密切相关,血清NLR、PLR对COPD-OSAS具有较高的诊断效能,可作为诊断的生物学标志。

Objective:To investigate the clinical significance of neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)in chronic obstructive pulmonary disease(COPD)-obstructive sleep apnea syndrome(OSAS)overlap syndrome.Methods:A total of 90 COPD patients admitted to Yulin First People's Hospital from June 2020 to June 2022 were selected as the COPD group.Forty-six patients with COPD-OSAS overlap syndrome belonged to the COPD-OSAS group,and 40 healthy subjects from the Yulin Physical Examination Center during the same period served as the control group.The general clinical data and serum inflammatory index levels were compared among the three groups.The role of NLR and PLR in the diagnosis of COPD-OSAS overlap syndrome was evaluated by receiver operating characteristic curve(ROC).Results:The neutrophil count(NEU),platelet count(PLT),NLR,and PLR in the COPD group and COPD-OSAS group were higher than those in the control group,lymphocyte count(LYM)was lower than that of the control group,and the difference was statistically significant(P<0.05).NEU,NLR,and PLR in COPD-OSAS group were higher than those in COPD group,and LYM was lower than that in COPD group,and the difference was statistically significant(P<0.05).The AUC of NLR for the diagnosis of COPD-OSAS was 0.916,the sensitivity was 80.40%,the specificity was 84.60%,and the cut-off value was 3.175.The AUC of PLR diagnosis was 0.667,the sensitivity was 50.00%,the specificity was 83.80%,and the cut-off value was 189.220.Conclusion:Serum NLR and PLR levels are closely related to COPD-OSAS overlap syndrome.Serum NLR and PLR have high diagnostic performance for COPD-OSAS and can be used as biological markers for diagnosis.