To Analyze The Levels And Clinical Significance Of Serum NLR,PLR And CRP In Patients With Acute Exacerbation Of Bronchiectasis

Objective: To investigate the serum levels and changes of white blood cell count(WBC),platelet count(PLT),c-reactive protein(CRP),neutrophils to lymphocytes ratio(NLR),platelet to lymphocyte ratio(PLR),platelet distribution width(PDW%),hematocrit(HCT%)in patients with acute exacerbation of bronchiectasis(AEBX),and explore their clinical significance.Methods:From January 2019 to October 2022,105 patients with bronchiectasis(BE)admitted to Yijishan Hospital,affiliated with the Wannan Medical College,were selected according to whether they were in acute bronchiectasis exacerbation(confirmed bronchiectasis patients had the following three or more symptoms worsened for more than 48 hours and required clinical treatment.Symptoms: Increased cough,sputum volume,sputum purulence,dyspnea or decreased exercise tolerance,fatigue,hemoptysis).Patients were grouped into control groups: bronchiectasis group;AEBX group: acute bronchiectasis plus recombination.General information such as sex,age,smoking history,hemoptysis and cough and sputum were recorded.Hematologic data collected within 24 h of admission included: WBC,PLT,lymphocyte absolute,neutrophils absolute,PDW%,HCT%,and CRP.To calculate NLR、PLR.The differences of WBC,PLT,CRP,NLR,PLR,PDW% and HCT% between the control group and the AEBX group were compared,and the receiver operating characteristic(ROC)curve was drawn.The area under curve(AUC),sensitivity and specificity of each index were calculated,and the relationship between the above indexes and patients with acute exacerbation of bronchiectasis was analyzed.The diagnostic value of these indexes for patients with acute exacerbation of bronchiectasis was explored,and the potential indexes with the highest diagnostic value were screened out.Results: Comparing the HCT between the control group and the AEBX group,the mean value of the AEBX group was higher than that of the control group,but P> 0.05,and the difference was not statistically significant.The levels of WBC,PLT,CRP,NLR,PLR and PDW% in the AEBX group were significantly higher than those in the control group(P<0.05).ROC curve analysis showed that the AUC of WBC was 0.802,and the best cut-off value corresponding to the maximum Youden index was calculated.Taking 7.100 as the cut-off value,the sensitivity was 63.2% and the specificity was85.7%.The AUC of PLT was 0.707,and 224.500 was selected as the critical value,with a sensitivity of 42.1% and a specificity of 91.7%.The AUC of CRP was 0.869,with 8.125 as the critical value,the sensitivity was 71.9%,and the specificity was95.8%.The AUC of NLR was 0.81,and 4.035 was selected as the critical value,the sensitivity was 68.4%,and the specificity was 91.7%.The AUC of PLR was 0.741,and 135.39 was selected as the critical value,the sensitivity was 68.4%,and the specificity was 79.2%.The AUC of PDW% was 0.648,with a sensitivity of 83.3% and a specificity of 54.4% when the cut-off value was 16.15.The AUC of PDW% was small,indicating that this index had little diagnostic significance for AEBX patients,and CRP had the highest diagnostic value for AEBX patients.Conclusion: The WBC,PLT,CRP,NLR,PLR,and PDW% can assist in the diagnosis of AEBX,Increased clinical understanding of the relationship between AEBX and peripheral blood markers has some predictive value for the early diagnosis of AEBX and has implications for early clinical treatment of AEBX patients.The diagnostic value of HCT% for AEBX needs to be further investigated.