PLR和NLR在慢性阻塞性肺疾病急性加重病情评估中的临床价值  

Clinical value of PLR and NLR in evaluation of disease condition of patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：胡斯明 徐晓[1] 徐国鹏[1] 李勇[1] 徐莉[1] HU Si-ming;XU Xiao;XU Guo-peng(Department of Respiratory Medicine,Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州医院呼吸科

出　　处：《中国实用医药》2019年第33期7-10,共4页China Practical Medicine

基　　金：江苏省苏州市卫生计生委科技项目(项目编号：LCZX201712)

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)在慢性阻塞性肺疾病急性加重(AECOPD)病情评估中的临床价值。方法选择55例AECOPD患者作为AECOPD组,54例慢性阻塞性肺疾病稳定期(SCOPD)患者作为SCOPD组,同期体检的60例健康体检者作为对照组。比较三组研究对象基本资料、NLR、PLR、第1秒用力呼气容量占预计值的百分比(FEV1%)、BODE指数;比较AECOPD不同肺功能分级患者NLR、PLR、FEV1%、BODE指数;分析NLR、PLR与BODE指数的相关性,NLR、PLR在AECOPD中的诊断效能。结果对照组烟龄短于SCOPD组、AECOPD组,差异具有统计学意义(P<0.05);SCOPD组、AECOPD组患者烟龄比较差异无统计学意义(P>0.05)。三组研究对象年龄、体质量指数(BMI)比较差异无统计学意义(P>0.05)。三组研究对象NLR、PLR、FEV1%、BODE指数比较差异具有统计学意义(P<0.05)。AECOPD肺功能分级Ⅰ级8例,Ⅱ级12例,Ⅲ级16例,Ⅳ级19例。AECOPD不同肺功能分级患者NLR、PLR、FEV1%、BODE指数比较差异具有统计学意义(P<0.05),随着分级的增加,NLR、PLR、BODE指数增加,FEV1%降低。NLR、PLR与BODE指数呈正相关(r=0.751、0.748,P<0.05)。NLR的ROC曲线下面积为0.87,95%CI=(0.139,0.731),敏感度为88%,特异度为86%;PLR的ROC曲线下面积为0.74,95%CI=(0.614,0.902),敏感度为82%,特异度为80%。结论NLR和PLR对AECOPD有较好的诊断效能,与BODE指数具有相关性,可作为评估慢性阻塞性肺疾病病情及预后的便捷、实用的临床指标。Objective To discuss the clinical value of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)in evaluation of disease condition of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods There were 55 AECOPD patients as AECOPD group,54 patients with stable-stage chronic obstructive pulmonary disease(SCOPD)as SCOPD group,and 60 healthy people as the control group.The basic data,forced expiratory volume in the first second as percentage of predicted value(FEV1%)and BODE index was compared in three groups,and NLR,PLR,FEV1%and BODE index was compared in patients with different pulmonary function grades of AECOPD.The correlation between NLR,PLR and BODE index,and diagnostic efficiency of NLR and PLR in AECOPD was analyzed.Results The smoking time of control group was shorter than those of SCOPD group and AECOPD group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in smoking time between SCOPD group and AECOPD group(P>0.05).There was no statistically significant difference in age and body mass index(BMI)in three groups(P>0.05).There was statistically significant difference in NLR,PLR,FEV1%and BODE index among three groups(P<0.05).The AECOPD pulmonary function classification gradeⅠin 8 cases,gradeⅡin 12 cases,gradeⅢin 16 cases and gradeⅣin 19 cases.There were statistically significant differences in NLR,PLR,FEV1%and BODE index among the patients with different pulmonary function grades of AECOPD(P<0.05).With the increase of grades,NLR,PLR,BODE index increased,FEV1%decreased.NLR and PLR were positively correlated with BODE index(r=0.751、0.748,P<0.05).The area under ROC curve of NLR was 0.87,95%CI=(0.139,0.731),sensitivity was 88%,specificity was 86%;the area under ROC curve of PLR was 0.74,95%CI=(0.614,0.902),sensitivity was 82%,specificity was 80%.Conclusion NLR and PLR shows good diagnostic effect on AECOPD,and are correlated with BODE index.They can be used as a convenient and practical clinical i

关 键 词：慢性阻塞性肺疾病 急性加重 中性粒细胞 淋巴细胞 血小板 

分 类 号：R73[医药卫生—肿瘤]