Correlation Study Of RDW,MPV,NLR And AECOPD Combined With Type Ⅱ Respiratory Failure

Objective:To investigate the differences of erythrocyte distribution width（RDW）,neutrophil/lymphocyte（NLR）and mean platelet volume（MPV）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）combined with type II respiratory failure and patients with AECOPD alone,and to analyze the correlation of each index with type II respiratory failure and its predictive value for the disease.The aim is to provide reference for the possible occurrence of type II respiratory failure in patients with AECOPD,and to provide timely help and early intervention for patients with type II respiratory failure in AECOPD.Methods:A total of 188 AECOPD patients with complete data who were admitted to Linfen People’s Hospital from January 2020 to March 2022 were selected.According to the results of arterial blood gas analysis of PaCO₂and Pa O₂on admission,they were divided into AECOPD group and AECOPD combined with typeⅡrespiratory failure group.There were 34 females and 60 males,and 94 patients with AECOPD complicated with typeⅡrespiratory failure,including 22 females and 72 males.The average age of the two groups was 70.36±9.79 and 69.95±9.85 years,respectively.Neutrophil to lymphocyte ratio（NLR）and body mass index（BMI）were calculated according to the formula.The differences in general data and laboratory data（RDW,NLR,MPV）between the two groups were compared.Spearman test was used to analyze the correlation between RDW,NLR,MPV and typeⅡrespiratory failure.Logistic regression analysis was used to analyze the clinical data and laboratory data to find the risk factors.ROC curve was drawn to analyze the ability of RDW,MPV,NLR and the combination of the three to predict the occurrence of typeⅡrespiratory failure in AECOPD.Results:1.RDW and NLR were significantly different between the AECOPD group with typeⅡrespiratory failure and the AECOPD group alone,and the levels of RDW and NLR in the group with typeⅡrespiratory failure were higher than those in the group with typeⅱrespiratory failure alone（Z=-4.861,P<0.001;Z=-5.875,P<0.001）（Z=-4.861,P<0.001;Z=-5.875,P<0.001）,MPV was not significantly different between the two groups（Z=-0.981,P>0.05）.2.PaCO₂,Pa O₂,hs-CRP,BNP,SII,EOS and LYM in AECOPD combined with type II respiratory failure group and AECOPD alone group were significantly different,and the levels of Pa O₂,EOS and LYM in combined with type II respiratory failure group were lower than those in simple AECOPD group（Z=-11.592,P<0.001;Z=-3.289,P=0.001;Z=-6.585,P<0.001）,the levels of PaCO₂,hs-CRP,BNP and SII in the group with type II respiratory failure were higher than those in the group with AECOPD alone（Z=-11.607,P<0.001;Z=-4.024,P<0.001;Z=-3.918,P<0.001;Z=-4.064,P<0.001）.D-D,WBC and GRAN showed no significant difference between the two groups（P>0.05）.3.PaCO₂was correlated with RDW and NLR（r=0.270,P=0.009;r=0.209,P=0.043）.Pa O₂was correlated with RDW（r=-0.373,P<0.001）.There was no correlation between Pa O₂and NLR（P>0.05）.4.RDW was correlated with BNP（r=0.284,P=0.006）.NLR was correlated with hs-CRP,BNP,SII,EOS and LYM（r=0.341,P=0.001;r=0.319,P=0.002;r=0.744,P<0.001;r=-0.554,P<0.001;r=-0.648,P<0.001）.5.Multivariate regression analysis showed that RDW,NLR,BNP and LYM were risk factors for type II respiratory failure in AECOPD patients（P=0.006;P=0.014;P=0.042;P=0.001;P<0.001）.6.RDW,NLR separately predictⅡtype of respiratory failure of AECOPD patients AUC is 0.705,0.748,0.7<AUC<0.9 said has certain prediction efficiency of RDW and NLR combined prediction of AUC 0.788,both the prediction efficiency than separate numerical prediction efficiency is high,the sensitivity and specificity of 60.6%,86.2%respectively.Conclusion:Compared with AECOPD group,RDW and NLR levels in AECOPD group combined with typeⅡrespiratory failure were increased,and for AECOPD group combined with typeⅡrespiratory failure,RDW and NLR levels were correlated with typeⅡrespiratory failure.In addition,RDW and NLR had certain predictive value for the occurrence of typeⅡrespiratory failure in AECOPD group.The predictive value is higher when the two are combined.Therefore,RDW and NLR are good biological predictors of type II respiratory failure in AECOPD,and have good diagnostic value for the occurrence and development of the disease.