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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2022年01期

页码:

20-23

栏目:

论著

出版日期:

2022-02-20

文章信息/Info

Title:

Diagnostic and prognostic significance of NLR in patients with COPD complicated with CAP and AECOPD

作者:

焦桂微¹; 王新婷²; 任强¹; 王瑛¹; 刘晓民¹

150001 黑龙江,哈尔滨医科大学附属第一医院呼吸内科¹ 272000 山东,济宁市第一人民医院感染性疾病科²

Author(s):

Jiao Guiwei¹;  Wang Xinting²;  Ren Qiang¹;  Wang Ying¹;  Liu Xiaomin¹.

¹Department of Respiratory Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China; ²Department of Infectious Diseases, Jining first People's Hospital, Jining 272000, China

关键词:

中性粒细胞与淋巴细胞比值;  急性加重; 肺疾病; 慢性阻塞性;  社区获得性肺炎

Keywords:

Neutrophil to lymphocyte ratio;  Chronic obstructive pulmonary disease;  acute exacerbation;  Community acquired pneumonia

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2022.01.005

摘要:

目的 对比分析中性粒细胞与淋巴细胞比值(NLR)在慢性阻塞性肺疾病(COPD)合并社区获得性肺炎(CAP)和COPD急性加重期(AECOPD)患者中的鉴别诊断价值及评估预后的潜力。方法 选择2017年1月至2019年12月在哈尔滨医科大学附属第一医院呼吸内科及重症监护病房(ICU病房)符合条件的1 215例COPD患者为对象,依据诊断标准分为COPD合并CAP组783例和AECOPD组432例。使用Spearman相关分析,分析NLR与其他炎性指标(WBC、PCT、CRP、FIB)的相关性; 绘制受试者工作特征(ROC)曲线,分析NLR对于COPD合并CAP与AECOPD的诊断价值及评估预后的潜力。结果 Spearman相关分析显示:两组的NLR与其他炎性指标均有明显相关性(P<0.001); ROC曲线分析显示对于3.987的NLR的截断值,鉴别两组的灵敏度为56%,特异性66%,AUC为0.627; NLR在预测ICU入住率、住院期间病死率、有创及无创机械通气使用率方面,COPD合并CAP组AUC分别为:0.79、0.773、0.791、0.726; AECOPD组AUC分别为:0.874、0.915、0.862、0.74。结论 NLR水平在一定程度上可以鉴别 COPD合并CAP与AECOPD,但准确性不高; NLR较其他炎性指标在预测ICU入住率、住院期间病死率、机械通气使用率方面表现出显著优势。

Abstract:

Objective To compare and analyze the value of NLR in the differential diagnosis of COPD complicated with CAP and AECOPD patients and its potential in evaluating prognosis. Methods The electronic medical records of all eligible 1215 COPD patients hospitalized in the Department of Respiratory Medicine and Intensive Care Unit(ICU)of the First Affiliated Hospital of Harbin Medical University from January, 2017 to December, 2019 were collected. According to the relevant diagnostic criteria, they were divided into COPD complicated with CAP group(783 cases)and AECOPD group(432 cases). By the Spearman correlation analysis, to analyze the correlation between NLR and other inflammatory indexes(WBC, PCT, CRP, FIB); By drawing the work of receiver operating characteristic(ROC)curve, to analyze the potential of NLR in the diagnosis and prognosis of COPD complicated with CAP and AECOPD. Results Spearman correlation analysis show that NLR is significantly correlated with other inflammatory indexes(P<0.001). ROC curve analysis show that for the cut-off value of 3.987 NLR, the sensitivity, specificity and AUC of the two groups are 56%, 66% and 0.627 respectively. The AUC of NLR in predicting ICU occupancy rate, in hospital mortality, invasive and noninvasive mechanical ventilation utilization rate are 0.79, 0.773, 0.791 and 0.726 in COPD complicated with CAP group, and 0.874, 0.915, 0.862 and 0.74 in AECOPD group. Conclusion NLR level can distinguish COPD complicated with CAP and AECOPD to some extent, but the accuracy is not high. NLR has significant advantages in predicting occupancy rate, in hospital mortality and mechanical ventilation rate of ICU compared with other inflammatory indexes.

参考文献/References:

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备注/Memo

备注/Memo:

基金项目: 国家重点研发计划项目-东北地区重大慢病防控科技综合示范研究项目(2018YFC1311600)
通信作者: 刘晓民, Email: liuxiaominhuxi@126.com

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更新日期/Last Update: 2022-02-20