hs-CRP联合NLR对COPD患者营养状况的预测价值

Predictive value of hs-CRP combined with NLR on nutritional status in patients with COPD

目的研究慢性阻塞性肺疾病(COPD)患者炎性指标超敏C反应蛋白(hs-CRP)、中性粒细胞/淋巴细胞(NLR)与营养不良的关系及其对营养不良的的预测作用。方法选取2018年9月~2020年4月于华北理工大学附属医院呼吸与重症医学科诊断为COPD患者84例,根据体质量指数(BMI)分为两组,营养不良组17例(BMI<18.5 kg/m^(2)),营养正常组67例(BMI≥18.5 kg/m^(2))。收集两组患者的一般资料、hs-CRP、中性粒细胞、淋巴细胞等相关数据,比较hs-CRP、NLR以及两项指标联合时的ROC曲线下面积以评价其对COPD合并营养不良风险的预测效能。结果营养不良组与营养正常组的hs-CRP、NLR值比较差异有统计学意义(P<0.05)。营养不良组患者的BMI、白蛋白、前白蛋白均与hs-CRP、NLR呈负相关,差异有统计学意义(P<0.05)。hs-CRP预测COPD患者营养不良时,敏感性为0.50,特异为0.85,ROC曲线下面积为0.66(95%CI 0.49~0.83),NLR预测COPD患者营养不良时,敏感性为0.88,特异为0.50,ROC曲线下面积为0.67(95%CI 0.54~0.79),二者联合预测时,敏感性为0.93,特异为0.40,ROC曲线下面积为0.68(95%CI 0.54~0.83)。结论hs-CRP、NLR水平与COPD患者营养状态密切相关,两者联合检测对预测COPD患者营养不良有较高的预测作用。

ObjectiveTo study the relationship between inflammatory markers hs-CRP,NLR and malnutrition in patients with COPD,and their predictive role in malnutrition.MethodsA total of 84 patients with COPD who were diagnosed with COPD in the Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of North China University of Science and Technology from September 2018 to April 2020 were selected.According to the body mass index(BMI),17 patients in malnutrition group(BMI<18.5 kg/m^(2))and 67 patients in normal nutrition group(BMI≥18.5 kg/m^(2))were divided into two groups.The general information,hs-CRP,neutrophils,lymphocytes and other relevant data of the two groups of patients were collected,and hs-CRP,NLR,the area under the ROC curve when hs-CRP and NLR were combined were compared to evaluate their predictive efficacy for the risk of COPD combined with malnutrition.ResultsThere were obviously differences in hs-CRP and NLR values between malnutrition group and normal nutrition group(P<0.05).BMI,albumin and prealbumin in malnutrition group were negatively correlated with hs-CRP and NLR It was found that when hs-CRP predicted COPD malnutrition,the sensitivity value was 0.50,the specificity value was 0.85,and the area under the ROC curve was equal to 0.66(95%CI 0.49~0.83).When NLR predicted malnutrition in COPD patients,the sensitivity value was 0.88,the specificity value was 0.50,and the area under the ROC curve was equal to 0.67(95%CI 0.54~0.79).When the two inflammatory markers were predict together,the sensitivity was as high as 0.93,the specificity value was 0.40,the area under the ROC curve was equal to 0.68(95%CI 0.54~0.83).ConclusionThe levels of hs-CRP and NLR are closely related to the nutritional status of COPD patients,and the combined detection of the two has high efficacy in assessing malnutrition in COPD patients.