AECOPD患者外周血EOS、D-D和NLR与肺通气功能的关系

The relationship between EOS,D-D and NLR in peripheral blood and pulmonary ventilation in patients with AECOPD

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者外周血嗜酸性粒细胞(EOS)、D-二聚体(D-D)和中性粒细胞/淋巴细胞比值(NLR)变化及与肺通气功能的关系。方法分别选择AECOPD患者(观察组)和慢性阻塞性肺疾病(COPD)患者(对照组)各65例。收集患者基本资料并进行实验室指标检查,测定EOS、D-D水平,并计算NLR。检测肺功能指标第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)及血气指标动脉血氧分压[p(O_(2))]和动脉血二氧化碳分压[p(CO_(2))]。多因素Logistic回归分析AECOPD的影响因素。采用R4.2.3建立AECOPD的列线图模型并进行验证。结果与对照组比较,观察组EOS、D-D、NLR水平升高,FEV1、FEV1/FVC水平降低(P<0.05)。多因素Logistic回归分析结果显示,EOS、D-D、NLR升高以及FEV1/FVC、FEV1降低是患者发生AECOPD的独立危险因素(P<0.05)。AECOPD列线图模型的受试者工作特征(ROC)曲线下面积为0.817(95%CI:0.784~0.904),Hosmer-Lemeshow检验结果显示该模型的拟合优度较好(χ^(2)=4.320,P>0.05)。EOS、DD、NLR均与FEV1、FEV1/FVC呈正相关(P<0.05)。结论EOS、D-D、NLR水平升高是影响AECOPD患者肺通气功能的危险因素,可作为评估肺通气功能的重要指标。

Objective To investigate changes of peripheral blood eosinophils(EOS),D-dimer(D-D)and neutrophil/lymphocyte ratio(NLR)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their relationship with pulmonary ventilation function.Methods Sixty-five AECOPD patients(the observation group)and 65 COPD patients(the control group)were selected respectively and included in this study.Basic data were collected in the two groups of patients,and laboratory indexes were examined.EOS and D-D levels were determined,and NLR was calculated.The lung function indexes including the first second expiratory volume with exertion(FEV1),the first second expiratory volume with exertion as a percentage of expiratory lung capacity with exertion(FEV1/FVC),and blood gas indexes of arterial blood partial pressure of oxygen[p(O_(2))]and arterial blood partial pressure of carbon dioxide[p(CO_(2))]were detected.Multifactorial Logistic regression was used to analyze the influencing factors of AECOPD.The nomogram model of AECOPD was established and verified by R4.2.3.Results Compared with the control group,levels of EOS,D-D and NLR were elevated,and FEV1 and FEV1/FVC levels were reduced in the observation group(P<0.05).Multifactorial Logistic regression analysis showed that elevated EOS,D-D and NLR,and reduced FEV1/FVC and FEV1 were independent risk factors for patients with AECOPD(P<0.05).The area under the receiver operating characteristic(ROC)curve of AECOPD nomogram model was 0.817(95%CI:0.784-0.904),and the Hosmer-Lemeshow test showed goodness of fit of the model(χ^(2)=4.320,P>0.05).EOS,D-D and NLR were positively correlated with FEV1 and FEV1/FVC(P<0.05).Conclusion The elevated levels of EOS,D-D and NLR are risk factors that affect pulmonary ventilation in AECOPD patients,which can be used as an important indicator to evaluate pulmonary ventilation function.