RCI、LHR、NLR与AECOPD患者Ⅱ型呼吸衰竭的关系及对短期预后不良的预测价值

Relationship between RCI,LHR,NLR and Type II Respiratory Failure in AECOPD Patients and Its Predictive Value for Poor Short-term Prognosis

目的:探讨红细胞指数(RCI)、淋巴细胞与高密度脂蛋白比值(LHR)、中性粒细胞与淋巴细胞比值(NLR)与慢性阻塞性肺疾病急性加重期(AECOPD)患者Ⅱ型呼吸衰竭的关系及对短期预后不良的预测价值。方法:收集2019年1月至2021年12月于徐州医科大学第二附属医院就诊的139例AECOPD患者的临床资料。根据患者是否发生Ⅱ型呼吸衰竭分为呼吸衰竭组(n=47)和无呼吸衰竭组(n=92),随访以上患者出院90天内的预后情况,剔除失访和死亡病例,分为预后不良组(n=26)与预后良好组(n=101),计算RCI、LHR以及NLR比值,多因素Logistic回归分析影响AECOPD患者短期预后不良的因素,受试者工作特征(ROC)曲线分析RCI、LHR以及NLR比值在AECOPD患者短期内预后不良中的研究价值。结果:呼吸衰竭组NLR、RCI高于无呼吸衰竭组,LHR低于无呼吸衰竭组(P<0.05)。预后不良组COPD病程长于预后良好组,NLR、RCI高于预后良好组,BMI、LHR低于预后良好组(P<0.05)。多因素Logistic回归分析显示NLR、RCI升高与LHR降低均是AECOPD患者短期预后不良的独立危险因素(P<0.05)。ROC曲线分析显示,RCI、LHR与NLR预测AECOPD患者短期预后不良的曲线下面积(AUC)分别为0.720、0.681、0.770,三者联合的AUC为0.863,联合预测时的AUC最大。结论:RCI、LHR及NLR可在一定程度上评估AECOPD患者严重程度,为短期预后不良的危险因素,在预测短期预后不良方面具有较高价值。

Objective:To explore the relationship between red cell index(RCI),lymphocyte/high density lipoprotein ratio(LHR),neutrophil/lymphocyte ratio(NLR)and type II respiratory failure in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its predictive value for poor short-term prognosis.Methods:The clinical data of 139 AECOPD patients who visited the Second Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2021 were collected.Patients were divided into respiratory failure group(n=47)and non respiratory failure group(n=92)according to whether they had type II respiratory failure,the prognosis of above patients within 90 days of discharge were followed up,excluded cases of lost to follow-up and death,patients were divided into poor prognosis group(n=26)and good prognosis group(n=101),the RCI,LHR and NLR ratios were calculated,Multivariate Logistic regression analysis affecting for poor short-term prognosis of AECOPD patients,the research value of RCI,LHR and NLR ratios in short-term prognosis of AECOPD patients were analyzed by receiver operating characteristic(ROC)curve.Results:NLR and RCI in respiratory failure group were higher than those in non respiratory failure group,LHR was lower than that in non respiratory failure group(P<0.05).The course of COPD in poor prognosis group was longer than that in good prognosis group,NLR and RCI were higher than those in good prognosis group,body mass index(BMI)and LHR were lower than those in good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that increased NLR,RCI and decreased LHR were independent risk factors for poor short-term prognosis of AECOPD patients(P<0.05).ROC curve analysis showed that,the area under the curve(AUC)of RCI,LHR and NLR in predicting for poor short-term prognosis of AECOPD patients were 0.720,0.681 and 0.770 respectively.The combined AUC of three was 0.863,and the AUC of combined prediction was the largest.Conclusion:RCI,LHR and NLR can evaluate the severity of AECOPD patients to a certain extent,which are risk factors for poor short-term prognosis,and have a high predictive value for poor short-term prognosis.