Clinical Significance Of NLR And PBE In AECOPD With Respiratory Failure And Independent Risk Factor Analysis

Objective1.To explore the value of NLR and PBE in evaluating and predicting AECOPD with respiratory failure2.To explore the independent risk factors of AECOPD with respiratory failureMethods:A retrospective analysis of 780 AECOPD patients admitted to the Department of Respiratory Medicine,Second Affiliated Hospital of Hainan Medical College from April to May 2018,361 patients were eligible according to inclusion criteria and exclusion criteria.Collect general patient data,vital signs at admission,laboratory parameters within 24 hours of admission,and hospitalization costs.Divided into respiratory blood pressure(PaO2)and/or arterial carbon dioxide partial pressure(PaCO2)values based on blood gas analysis at admission.Failure group and non-respiratory failure group.Neutrophil/lymphocyte(NLR),body mass index(BMI),mean arterial pressure(MAP),acute physiology and chronic health score(APACHE-Ⅱ),and chronic obstructive pulmonary disease physiology score(CAPS)were calculated by the formula..Through correlation analysis,NLR and PBE were used to evaluate the diagnostic value of AECOPD combined with respiratory failure severity.NLR and PBE were analyzed by receiver operating characteristic curve(ROC)to predict the ability of AECOPD to develop respiratory failure.Logistic regression analysis of clinical data was performed to find independent influencing factors of AECOPD combined with respiratory failureResults:1.NLR was higher in the respiratory failure group than in the non-respiratory failure group(P<0.01)2.PBE was lower in the respiratory failure group than in the non-respiratory failure group,and the difference was statistically significant(P<0.01)3.PCT and D-D were higher in the respiratory failure group than in the non-respiratory failure group,and the difference was statistically significant(P<0.01)4.NLR was positively correlated with PCT,DD,PaCO2,APACHE-Ⅱ,and hospitalization expenses.The correlation coefficients were(0.402,0.118,0.127,0.33,0.363);NLR was negatively correlated with PaO2,and the correlation coefficient was(-0.159).The above differences were statistically significant(P<0.05)5.There was a negative correlation between PBE and PCT,APACHE-Ⅱ,and hospitalization expenses.The correlation coefficients were(-0.31,-0.246,-0.242),and the above differences were statistically significant(P<0.05)6.NLR predicts that the ROC curve of AECOPD combined with respiratory failure is 0.622,the 95%confidence interval is(0.564-0.68),the critical value is 6.34,the sensitivity is 0.47,and the specificity is 0.7697.PBE percentage prediction The area under the ROC curve of AECOPD without respiratory failure was 0.577,the 95%confidence interval was(0.518-0.636),the critical value was 0.25%,the sensitivity was 0.47,and the specificity was 0.769The multivariate logistic regression analysis was performed on the index of P<0.05 in the single factor logistic regression analysis.The results showed that the regression coefficients of HR,BMI and Na+were(0.020,-0.140,-0.166),respectively.0.05,the difference was statistically significantConclusions:1.NLR and PBE have certain value in evaluating the severity of AECOPD with respiratory failure.2.Heart rate,body mass index,blood sodium is an independent influencing factor of AECOPD combined with respiratory failure.