Clinical Value Of NLR,PLR In Chronic Obstructive Pulmonary Disease

Objective:By comparing and analyzing the white cell count(WBC),neutrophil count(NEU),lymphocyte count(LYM),and platelet count(PLT)in the blood cell analysis,calculate the neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and explore the clinical value of NLR,PLR in chronic obstructive pulmonary disease(COPD),and compared with C-reactive protein(CRP).Methods:In this study,the clinical data of 167 hospitalized patients diagnosed with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)admitted to the Department of Respiratory Medicine during the period from October 2016 to April 2018 were retrospectively collected.In the past month,157 COPD patients without acute exacerbations were used as stable chronic obstructive pulmonary disease(SCOPD)data.At the same time,clinical data of 146 gender-and age-matched patients in our hospital during the same period were taken as the reference group.1.The Kruskal-Wallis H test was used to analyze the differences in blood cell analysis and CRP among the AECOPD group,the SCOPD group,and the healthy control group.ROC curve analysis was used to evaluate the diagnostic efficacy of relevant indicators for acute exacerbation of COPD.NLR,PLR were used to predict the value of the risk of COPD acuteness.2.157 SCOPD patients with lung function tests were selected and divided into grades I-IV according to GOLD(2017 version).The Kruskal-Wallis H test was used to compare differences in CRP and blood cell analysis among different grades to investigate the correlation between the NLR,PLR and the lung function of COPD patients.3.167 patients with AECOPD were.divided into the improved discharge group and the non-impulsive discharge group.The Mann-Whitney U test was used to compare the differences between the CRP and blood cell analysis of the two groups to investigate the relationship between NLR,PLR and the prognosis of AECOPD patients.4.167 patients with AECOPD were divided into no respiratory failure group and type II respiratory failure group.Mann-Whitney U test was used to compare the difference between CRP and blood cell analysis of the two groups,to predict the value of respiratory failure in AECOPD patients by NLR,PLR.Results:1.There was no significant difference in gender and age among AECOPD group,SCOPD group and healthy control group.Compared with the healthy control group and the SCOPD group,the NEU,NLR,PLR,and CRP in the AECOPD group were significantly increased,and LYM was significantly decreased(P<0.05).ROCcurve analysis showed that CRP,AUC was 0.845,8.32 was selected as the cutoff value,sensitivity was 83.2%,specificity was 78.5%;ALR of NLR was 0.819,3.83 was selected as the cutoff value,sensitivity was 68.3%,specificity was 80.5%The PLR had an AUC of 0.678 and 143.95 was selected as the cutoff value,with a sensitivity of 60.5%and a specificity of 71.0%.2.According to GOLD(2017 version)classification of lung function,SCOPD patients were divided into grades I-IV.Grade ?(8 cases),grade II(48 cases),grade III(65 cases),and grade IV(36 cases).There was no significant difference in blood cell analysis and CRP index among patients with I-IV COPD.3.Among the 167 patients with AECOPD,97 were discharged from hospital and 70 patients did not get better,including death(2 cases),automatic discharge(50 cases),untreated(15 cases),transfer to hospital(3 cases).Compared with the discharge group,the WBC,NEU,PLT,NLR,and PLR of the non-improved discharge group were significantly higher and LYM was decreased(P<0.05).There was no difference in CRP between the two groups.4.Among the 167 patients with AECOPD,blood gas analysis was used to classify patients with type ? respiratory failure(n=54)and without respiratory failure(n=113).Compared with the group without respiratory failure,WBC,NEU,NLR,and PLR were significantly higher in the combined type ? respiratory failure group,and LYM was decreased(P<0.05).There was no significant difference in PLT and CRP between the two groups.Conclusions:Peripheral blood cell analysis,especially NLR and PLR,has a high diagnostic value for AECOPD,but it has limited effect on assessing the severity of COPD.Compared with CRP,NLR and PLR have obvious advantages in predicting AECOPD with type ? respiratory failure and treatment outcome.Blood cell analysis is simple,convenient,and inexpensive.In summary,NLR and PLR can be used as an effective auxiliary tool for disease management in primary hospital COPD patients.