Correlation Between Neutrophil/lymphocyte Ratio And Clinical Grade In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:Objective:To investigate the correlation between the peripheral blood neutrophil-lymphocyte ratio（NLR）and the clinical grade of AECOPD in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods:The grouping research was performed in 72 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory and Critical Care Medicine of the Affiliated Hospital of yanbian university from January 2019to December 2019,and each patient with AECOPD met diagnostic criteria of GOLD2020and expert consensus on acute exacerbation of chronic obstructive pulmonary disease in the People’s Republic of China（2017 edition）.The enrolled patients with AECOPD were all able to complete the pulmonary function test and the results of tests were met the standard that the ratio of first second expiratory volume（FEV1）to forceful lung volume（FVC）（FEV1/FVC）was less than 70%after the application of bronchodilator.Among 72patients,43 patients were males and 29 were females,and 52 were with smoking history and 20 were without smoking history.Patients hospitalized with AECOPD were graded according to the presence or absence of respiratory failure,respiratory frequency,whether to apply auxiliary respiratory muscles,the changes of conscious state,the presence or absence of hypoxemia and hypercapnia,the severity of acute exacerbation and clinical manifestations,and then divided into three groups:grade Ⅰ,grade Ⅱ and grade Ⅲ.The present study aimed to investigate the changes of NLR among the three groups with AECOPD and the correlation between NLR and CRP and PCT among them.Results:The results of this study were as follows:1)There were no statistical differences in gender,age,smoking history and body mass index among the AECOPD grade Ⅰ,Ⅱ and Ⅲ;2)the level of NLR was higher in AECOPD grade Ⅲ patients than in AECOPD grade Ⅰ,but the level of Lym was lower than in AECOPD grade Ⅰ,and both showed the significant differences.However,the levels of Net,CRP and PCT did not show significant differences among the AECOPD grade Ⅰ,Ⅱ and Ⅲ;3)NLR was positively correlated with CRP and PCT,and negatively correlated with ALB and PO2;4)The results of ROC curve analysis of NLR for predicting AECOPD grade Ⅱ and grade Ⅲ showed that the area under the curve for predicting AECOPD grade Ⅱ was 0.740（95%CI:0.605-0.848）with a critical value of 4.19,sensitivity of 78.6%,and specificity of 76.2%;and the area under the curve for predicting AECOPD grade Ⅲ was 0.807（95%CI:0.682-0.899）,with a critical value of 4.19,sensitivity of 75.0%and specificity of 76.2%.Conclusions:1)The peripheral blood NLR values might become a biomarker due to the correlation with the clinical grading scales of AECOPD patients;2)The peripheral blood NLR values might be a biomarker to evaluate the efficacy of treatment of AECOPD and be used to guide clinical diagnosis and treatment due to the positive correlation with CRP and PCT and the negative one with ALB and PO₂.