哮喘患者外周血血小板-淋巴细胞比值和中性粒细胞-淋巴细胞比值的临床意义  

Clinical significance of peripheral blood neutrophil- lymphocyte ratio and plateletlymphocyte ratio in patients with asthma

作　　者：时光[1] 赵俊伟[1] 明亮[1] 

机构地区：[1]郑州大学第一附属医院检验科//河南省检验医学重点实验室//郑州大学医学检验系,河南郑州450052

出　　处：《南方医科大学学报》2017年第1期84-88,共5页Journal of Southern Medical University

基　　金：国家自然科学基金(81501715);河南省科技攻关项目(162102310142;152102410067)~~

摘　　要：目的探讨外周血中性粒细胞-淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)和血小板-淋巴细胞比值(plateletlymphocyte ratio,PLR)在支气管哮喘急性发作期患者中的变化及临床意义。方法选取2013年1月~2016年5月期间确诊的支气管哮喘急性发作期患者262例为病例组及130例健康体检者为正常对照组。根据其急性发作期病情严重程度,将哮喘患者分为危重组87例、非危重组175例。记录病例组和健康对照组性别、年龄等临床资料和血常规结果,并计算NLR和PLR。比较3组间中性粒细胞绝对值、淋巴细胞绝对值、血小板计数、NLR、PLR的差异,以ROC曲线评价各指标对哮喘的诊断价值。结果各组间中性粒细胞绝对值、淋巴细胞绝对值、NLR、PLR差异具有统计学意义(P<0.0001),各组血小板计数差异无统计学意义(P=0.971)。哮喘危重组淋巴细胞绝对值低于哮喘非危重组、健康对照组(P<0.0001),而中性粒细胞绝对值、NLR、PLR显著高于哮喘危重组、健康对照组(P<0.0001)。哮喘非危重组中性粒细胞绝对值、淋巴细胞绝对值、NLR、PLR与健康对照组相比差异无统计学意义(P>0.05)。中性粒细胞绝对值、淋巴细胞绝对值、NLR、PLR对支气管哮喘急性发作期危重患者诊断的曲线下面积分别为0.802、0.784、0.873、0.795(均P<0.01)。NLR诊断支气管哮喘急性发作期危重患者的最佳临界值为2.58,敏感度为82.8%,特异度为81.1%。结论支气管哮喘患者外周血NLR、PLR均升高,对支气管哮喘的诊断和病情监测有一定临床指导意义。Objective To investigate the changes of peripheral blood neutrophil-lymphocyte ratio （NLR） and platelet-lymphocyte ratio （PLR） in patients in acute stage of bronchial asthma and their clinical significance. Methods A total of 262 patients with acute asthma, including 97 critical and 175 non-critical patients, were recruited from our hospital between January, 2013 and May, 2016, with 130 healthy individuals as the control group. The absolute neutrophil count, absolute lymphocyte count, platelet, NLR and PLR were compared among different groups, and their diagnostic values were evaluated using the area under the receiver-operating characteristic （ROC） curve. Results The absolute neutrophil count, absolute lymphocyte count, PLR and NLR （P〈0.0001）, but not platelet count （P=0.971）, differed significantly among the 3 groups. The absolute lymphocyte count was significantly lower while the absolute neutrophil count, NLR and PLR were significantly higher in asthmatic patients in critical condition than in patients in non-critical condition and the control subjects （P〈0.0001）, and these parameters showed no significant differences between latter two groups （P〉0.05）. The areas under the curve of absolute neutrophil count, absolute lymphocyte count, NLR and PLR for the diagnosis of acute exacerbation of bronchial asthma were 0.802, 0.784, 0.873 and 0.795, respectively （all P〈0.01）;the optimal cut-off value of NLR was 2.58 for the diagnosis with a sensitivity of 82.8%and a specificity of 81.1%. Conclusion Peripheral blood NLR and PLR are increased in asthmatic patients, and their variations offer assistance in the diagnosis and assessment of bronchial asthma.

关 键 词：支气管哮喘 中性粒细胞-淋巴细胞比值 血小板-淋巴细胞比值 

分 类 号：R562.25[医药卫生—呼吸系统]