The Relationship Of Monocyte-lymphocyte Ratio In Assessing The Severity Of Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objectives The purpose of this study is to explore the relationship between monocytelymphocyte ratio(MLR)and the severity of acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to evaluate the value of MLR for the severity of AECOPD.It provides a new theoretical basis for judging the disease progression of AECOPD patients early and improving the success rate of AECOPD treatment.Methods A total of 427 AECOPD patients who were hospitalized in the Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of North China University of Science and Technology from January 2018 to October 2021 were brought into the research.Taking the combined respiratory failure as an indicator of the severity of the disease,they were divided into the AECOPD group with a total of 211 cases(the control group),AECOPD combined with respiratory failure group,a total of 216 cases(the case group).The first blood routine,biochemical routine,coagulation series,and underlying diseases were gathered within 24 hours of hospital admission.Univariate analysis and binary logistic regression were utilized to look for the relationship between MLR and the severity of AECOPD.By calculating the the receiver operating characteristic(ROC)curve of MLR,it was used to evaluate the predictive power of the severity of AECOPD,and the sensitivity and specificity were calculated to obtain the best cut-off point of MLR.Results 1 The difference was not statistically significant(P>0.05)between the control group and the case group in indicators such as gender,death,smoking,drinking,combined underlying disease,age,body mass index(BMI),white blood cells,neutrophils,hemoglobin,erythroid cell volume distribution,high-density lipoprotein,creatinine,and plasma fibrinogen.The difference was statistically significant between the two sets in hospital stay,platelet volume distribution width,lymphocyte,monocyte,MLR,neutrophil to lymphocyte ratio(NLR),eosinophils,eosinophils percentage,total protein,cholinesterase,total cholesterol,triglyceride,albumin,urea,prealbumin,D-dimer,erythrocyte sedimentation rate(P<0.05).2 The MLR levels in the case group was higher,there were significant differences in two groups(P<0.001).3 After binary logistic regression analysis,it was found that MLR,platelet volume distribution width and erythrocyte sedimentation rate were correlated with AECOPD severity(P<0.001),and among which MLR was more closely related to AECOPD severity,and MLR was independent risk factors for AECOPD severity.4 The area under the ROC curve of MLR was 0.708,the best critical cutoff point was 0.41,and the sensitivity and specificity were:0.648 and 0.668,respectively,indicating that it has a certain predicting value.However,the MLR prediction results had poor consistency with the actual results(Kappa=0.316),indicating that the clinical value of MLR used alone was limited.5.Results of sputum culture in the case group were: normal flora of respiratory tract,Pseudomonas aeruginosa,Aspergillus,Acinetobacter baumannii,Klebsiella pneumoniae.Conclusions 1 MLR is more closely related to the severity of AECOPD.Greater MLR values indicate greater AECOPD severity.2 MLR has a certain predictive ability to early predict the occurrence of of the deterioration of AECOPD,but the clinical utility of its use alone is limited.Figure2;Table11;Reference 241...