系统性炎症指标在哮喘-慢阻肺重叠鉴别诊断中的运用价值

Application value of systemic inflammatory index in thedifferential diagnosis of asthma-COPD overlap

目的分析系统性炎症指标在哮喘-慢阻肺重叠中的诊断价值。方法选取2021年1月-2022年12月本院收治的247例慢性呼吸道疾病患者,根据临床诊断分为ACO组(88例),Asthma组(75例),COPD组(84例),比较3组患者基线资料及系统性炎症指标的差异。通过受试者工作特征曲线评价各指标对ACO的鉴别效能。结果3组患者NLR、PLR、LMR、SII及SIRI间的差异均有统计学意义(P<0.05)。NLR>3.420、PLR>162.17、SII>772.26、SIRI>1.475、LMR<2.645五个指标联合诊断Asthma与ACO的ROC曲线下面积为0.758(95%CI:0.682~0.833,P<0.05),具有较好的诊断效能。结论COPD、Asthma与ACO 3组患者的NLR、PLR、LMR、SII、SIRI等系统性炎症指标分布有差异,且与其肺功能指标存在一定的相关性。联合运用5个指标对于Asthma与ACO的鉴别有一定的诊断价值。

Objective To analyze the diagnostic value of systemic inflammatory index in asthma-COPD overlap.Methods A total of 247 patients with chronic respiratory diseases were admitted to our hospital from January 2021 to December 2022,they were divided into ACO group(88 cases),Asthma group(75 cases)and COPD group(84 cases)according to clinical diagnosis.The differences of baseline data and systemic inflammation indexes among the three groups were compared.The identification efficiency of each index to ACO was evaluated by subject operating characteristic curve.Results The differences of NLR,PLR,LMR,SII and SIRI among the three groups were statistically significant(P<0.05).The area under ROC curve of five indexes with NLR>3.420,PLR>162.17,SII>772.26,SIRI>1.475,LMR<2.645,EBR<1.38 for combined diagnosis Asthma and ACO was 0.758(95%CI:0.682~0.833,P<0.05),which had good diagnostic efficacy.Conclusions There are differences in the distribution of systemic inflammatory indicators such as NLR,PLR,LMR,SII and SIRI in COPD,Asthma and ACO groups,and there is a certain correlation with their pulmonary function indicators.The combined application of 5 indexes has certain diagnostic value for the identification of Asthma and ACO.