The diagnostic value of serum NLR and eosinophils and eosinophils percentage in elderly patients with AECOPD
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摘要: 目的:对血清中性粒细胞与淋巴细胞比值(NLR)、嗜酸粒细胞、嗜酸粒细胞百分比在高龄慢性阻塞性肺疾病急性加重期(AECOPD)患者中诊断价值的研究。方法:选取年龄 ≥ 80岁的高龄男性AECOPD患者120例、COPD患者90例,分别称为急性加重组、稳定组,同时选取60例在老年病科住院体检、年龄 ≥ 80岁的高龄男性老人为对照组。采用回顾性研究方法,对急性加重组、稳定组、对照组中的NLR、嗜酸粒细胞、嗜酸粒细胞百分比水平进行比较,并对急性加重组中不同严重程度的Ⅰ级、Ⅱ级、Ⅲ级组NLR、嗜酸粒细胞、嗜酸粒细胞百分比水平进行比较。分析NLR、嗜酸粒细胞、嗜酸粒细胞百分比的相关性,并使用ROC曲线分别评估NLR、嗜酸粒细胞、嗜酸粒细胞百分比在高龄AECOPD患者中的检验效能。结果:NLR水平在急性加重组、稳定组、对照组间和Ⅰ级、Ⅱ级、Ⅲ级组间比较,差异有统计学意义(P<0.05);嗜酸粒细胞、嗜酸粒细胞百分比水平在急性加重组、稳定组、对照组间和Ⅰ级、Ⅱ级、Ⅲ级组间比较,差异无统计学意义(P>0.05)。NLR水平与中性粒细胞百分比、PaCO2水平呈正相关,与PaO2水平呈负相关;嗜酸粒细胞百分比水平与中性粒细胞百分比水平呈负相关。NLR、嗜酸粒细胞、嗜酸粒细胞百分比3项指标浓度的ROC曲线下面积为分别为0.842、0.436、0.380。结论:血清NLR水平对高龄AECOPD患者具有诊断价值,且为患者严重程度评估、特别是合并Ⅱ型呼吸衰竭患者的一个较为敏感指标。尚未发现嗜酸粒细胞、嗜酸粒细胞百分比在高龄AECOPD患者中的检验作用。
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关键词:
- 高龄 /
- 慢性阻塞性肺疾病急性加重期 /
- 中性粒细胞与淋巴细胞比值 /
- 嗜酸粒细胞 /
- 嗜酸粒细胞百分比
Abstract: Objective:To study the value of serum neutrophils to lymphocytes ratio(NLR), eosinophils and eosinophils percentage in diagnosis and severity assessment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 120 AECOPD and 90 COPD patients, aged ≥ 80 years old, were selected as the acute exacerbation group and the stable group, respectively. At the same time, 60 elderly male, aged ≥ 80 years old, were selected as the control group. The NLR, eosinophils and eosinophils percentages in acute exacerbation group, stable group and control group were compared by retrospective study method, and the levels of NLR, eosinophils and eosinophils percentages in grade Ⅰ, Ⅱ and Ⅲ groups with different severity of acute exacerbation group were compared. The correlation between NLR, eosinophils and eosinophils percentage was analyzed, and the ROC curve was used to evaluate the testing efficacy of NLR, eosinophils and eosinophils percentage in elderly patients with AECOPD.Results:The level of NLR was significantly different among acute exacerbation group, stable group, control group and grade Ⅰ, Ⅱ and Ⅲ(P<0.05). There was no significant difference in the eosinophils and eosinophils percentage among acute exacerbation group, stable group, control group and grade Ⅰ, Ⅱ and Ⅲ(P>0.05). NLR level was positively correlated with neutrophil percentage and PaCO2level, but negatively correlated with PaO2level. The eosinophils percentage was negatively correlated with the percentage of neutrophils. The areas under the ROC curve of NLR, eosinophils and eosinophils percentage were 0.842, 0.436 and 0.380, respectively.Conclusion:Serum NLR level has diagnostic value for elderly patients with AECOPD, and is a sensitive indicator for the severity assessment of patients, especially patients with type Ⅱ respiratory failure. The role of eosinophils and eosinophils percentage in elderly patients with AECOPD has not been found. -
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[1] 吕宪玉,刘淼,李嘉琦,等.80岁以上高龄老年人主要慢性病的疾病谱调查与分析[J].中华老年心脑血管病杂志,2016,18(9):917-919.
[2] 钱频,钱桂生.老年人慢性阻塞性肺疾病的诊断与治疗[J].中华肺部疾病杂志(电子版),2013,6(2):103-105.
[3] Aksoy E,Karakurt Z,Gungor S,et al.Neutrophil to lymphocyte ratio is a better indicator of COPD exacerbation severity in neutro-philic endotypes than eosinophilic endotypes[J].Int J Chron Ob-struct Pulmon Dis,2018,13:2721-2730.
[4] Tahto E,Jadric R,Pojskic L,et al.Neutrophil-to-lymphocyte-ratio and its relation with markers of inflammation and myocardial necrosis in patients with acute coronary syndrome[J].Med Arch,2017,71(5):312-315.
[5] Couillard S,Larivée P,Courteau J,et al.Eosinophils in COPD Exacerbations are associated with increased readmissions[J].Chest,2017,151(2):366-373.
[6] Shin SH,Park HY,Kang D,et al.Serial blood eosinophils and clinical outcome in patients with chronic obstructive pulmonary disease[J].Respir Res,2018,19(1):134.
[7] Turato G,Semenzato U,Bazzan E,et al.Blood eosinophilia neither reflects tissue eosinophils nor worsens clinical outcomes in chronic obstructive pulmonary disease[J].Am J Respir Crit Care Med,2018,197(9):1216-1219.
[8] 慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组.慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2017年修订版)[S].国际呼吸杂志,2017,37(14):1041-1057.
[9] 王胜奇,贺明轶,王晶.经鼻高流量氧疗与无创通气对慢性阻塞性肺疾病急性加重导致的Ⅱ型呼衰疗效对比[J].临床急诊杂志,2021,22(3):193-198.
[10] 张为,孙峰,杨建中,等.成人慢性气道炎症性疾病急症诊疗急诊专家共识[J].临床急诊杂志,2021,22(4),227-235.
[11] 王卿语,陈新军,武冬,等.中性粒细胞与淋巴细胞比值及红细胞分布宽度对脓毒症患者预后评估价值性[J].临床急诊杂志,2021,22(2),136-140.
[12] 王新婷,刘晓民,任强.NLR在COPD患者中的临床应用研究[J].中华肺部疾病杂志(电子版),2020,13(6):843-846.
[13] Gayaf M,Karadeniz G,Güldaval F,et al.Which one is superior in predicting 30 and 90 days mortality after COPD exacerbation:DECAF,CURB-65,PSI,BAP-65,PLR,NLR[J].Expert Rev Respir Med,2021,15(6):845-851.
[14] Taylan M,Demir M,Kaya H,et al.Alterations of the neutrophil-lymphocyte ratio during the period of stable and acute exacerbation of chronic obstructive pulmonary disease patients[J].Clin Respir J,2017,11(3):311-317.
[15] Bilir B,Altintas N,Aydin M,et al.The predictive role of neutrophil to lymphocyte ratio in chronic obstructive pulmonary disease[J].Eur J Gen Med,2016,13(2):105-110.
[16] Teng F,Ye H,Xue T.Predictive value of neutrophil to lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary disease[J].PLoS One,2018,13(9):e0204377.
[17] 叶涛,杨银,王凯,等.中性粒细胞/淋巴细胞比率预测慢性阻塞性肺疾病患者并发2型糖尿病的价值:前瞻性队列研究[J].南方医科大学学报,2017,37(10):1308-1314.
[18] 徐婷婷,宋伟伟,承璐潇,等.嗜酸粒细胞与慢性阻塞性肺病急性加重严重程度的关系[J].南京医科大学学报(自然科学版),2021,41(2):203-206,211.
[19] 赵新成,史家欣,梁程程,等.嗜酸粒细胞作为生物标志物在慢性阻塞性肺疾病中的研究进展[J].中国呼吸与危重监护杂志,2018,17(6):624-628.
[20] 香松林,寿志南,唐忠平.不同血嗜酸粒细胞水平的男性COPD患者使用ICS+LABA临床特征观察[J].贵州医药,2021,45(1):7-9.
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