Study On The Diagnostic Value Of Inflammatory Indexes In Routine Blood Test For Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To study the diagnostic value of blood routine inflammation indicators in the acute exacerbation of chronic obstructive pulmonary disease;and to explore the relationship between the severity of COPD airflow limitation and inflammatory cells in blood routine.methods:1.A total of 178 patients with AECOPD admitted to our hospital from January 2016to May 2019 were selected as the AECOPD group.100 healthy people in our hospital during the same period were selected as the healthy control group.Record general data of AECOPD patients before admission such as gender,BMI,age,smoking status,and length of hospital stay;collect routine blood parameters within 24 hours of admission,including:white blood cell count?WBC?,eosinophil percentage?EOS%?,platelet count?PLT?,absolute value of lymphocytes,percentage of neutrophils?NEU%?,absolute value of neutrophils;lung function parameters after treatment such as:one-second rate?FEV₁/FVC?,forced expiratory volume in the first second accounted for Value percentage?FEV₁%pre?,etc.Calculate NLR and PLR:NLR is the ratio of the absolute value of neutrophils to the absolute value of lymphocytes,PLR is the ratio of the absolute value of platelets and lymphocytes;compare the differences in NEU%,NLR,PLR,WBC,EOS%between the two groups;Draw the receiver operating characteristic?ROC?to analyze the difference in the diagnostic value of the above indicators for the acute exacerbation of COPD,calculate the sensitivity and specificity,clarify the diagnostic efficacy of blood routine inflammation indicators for AECOPD,and screen out The biomarker with the highest diagnostic value.2.AECOPD patients underwent lung function examination after hospitalization until the condition was stable,collected lung function examination data,and divided into3 groups according to the severity of COPD.74 cases in the moderate group?50%?FEV accounted for%<80%?,80 cases in the severe group?30%?FEV accounted for<50%?,24 cases in the severe group?FEV accounted for%<30%?;Compare the differences in NEU%,NLR,PLR,WBC,and EOS%between different groups to clarify the diagnostic and predictive significance of the above-mentioned inflammation indicators for the severity of different airflow limitation in COPD.Results:1.EOS%comparison between the two groups,although the AECOPD group was higher than the control group,P>0.05(?See Table 1?,the difference was not statistically significant;NLR,PLR,WBC,NEU%of the AECOPD group was greater than that of the healthy control group,and the difference was statistically significant?P<0.05??Table 1?.ROC curve analysis:the area under curve?AUC?of the NEU%ROC curve and the coordinate axis is 0.769,and the maximum Youden index is regarded as the optimal limit value,with 66.52 as the limit value,and the calculated sensitivity is 54.5%,Specificity is93.1%;NLR AUC is 0.792,2.57 is selected as the limit value,sensitivity is 58.4%,specificity is 91.1%;PLR AUC is 0.625,160.19 is the limit value,sensitivity is 38.8%,the specificity is 94.1%.The ABC of WBC is 0.633,and 6.785 is selected as the limit value.The calculated sensitivity is 42.1%,the specificity is 88.1%,and the AUC of EOS%is 0.425,indicating that this index is less meaningful for the diagnosis of COPD.2.The length of hospital stay in patients with moderate,severe,and extremely severe groups increased with the severity of airflow limitation,but the calculated P>0.05,the difference was not statistically significant;the difference between the number of smokers and BMI between the three groups was statistically significant,P<0.05.There were no significant differences in WBC,NEU,NLR,PLR,PCT and other inflammatory cells between the moderate,severe and extremely severe groups?P>0.05?.Conclusion:1.The commonly used indicators in blood routine such as WBC,NLR,PLR,NEU%,etc.are higher than the healthy control group.The above indicators can be used as an auxiliary method for diagnosing acute exacerbation of AECOPD.NLR has the highest diagnostic value for AECOPD.EOS%cannot effectively distinguish AECOPD patients from healthy people The diagnosis and treatment of COPD still needs further study.2.The test results show that WBC,NLR,PLR,NEU%cannot be used to evaluate the severity of COPD airflow limitation.