The Clinical Value Of Neutrophil To Lymphocyte Ratio And Distribution Width Of Erythrocytes In Patients With Chronic Obstructive Pulmonary Disease

BACKGROUND AND PURPOSE:This study will explore the change of the NLR and RDW in the period of acute exacerbation of chronic obstructive pulmonary disease,analysis the correlation of NLR and RDW with other inflammatory indexes,discussed the value of NLR and RDW joint used in the diagnosis of acute exacerbation of chronic obstructive pulmonary diseases and assess of the condition and prognosis.To find a new biomarker for the evaluation and prognosis of chronic obstructive pulmonary disease.OBJECT AND METHODS:A retrospective study was conducted to collect 100 patients who met the inclusion criteria of AECOPD between December 31,2016 and December 31,2018 at the 908 hospital of the joint logistic support force of the Chinese people’s liberation army.A total of 100 patients who met the inclusion criteria of COPD in the outpatient follow-up of our hospital and 100 healthy people in the physical examination center of our hospital were selected as the control group.1.The age and gender of the three groups were recorded,and the recording indexes of the AECOPD group were as follows: WBC,NC,LC,RDW,and hs-crp in peripheral blood within 24 hours after admission,respiratory failure at admission,and length of stay.Peripheral blood WBC,NC,LC,RDW,hs-CRP in COPD stable group and healthy control group.2.The number of acute exacerbation during the 1-year period after discharge of patients admitted to solstice on December 31,2016 and December 31,2017 were recorded.NLR was calculated from neutrophil count and lymphocyte count.Measurement data with mean + /-standard deviation,said the mean differences between the two groups compared with independent samples t test,multiple sets of comparison between using single factor analysis of variance,NLR,RDW and Spearman correlation analysis to the relationship between each index and the ROC curve to calculate the NLR AECOPD and RDW used in diagnosis of sensitivity,specific,and calculate the about index and cutoff value,calculate the NLR joint RDWfor diagnosing value of AECOPD.All data were collected using SPSS25.0 for Windows.P < 0.05 was selected as statistically significant.RESULTS:1.Serum WBC,NLR,RDW and hs-CRP levels of AECOPD patients were higher than those of COPD stable patients and normal control group(P < 0.05,the difference was statistically significant),while those of COPD stable patients were higher than those of normal control group(P < 0.05,the difference was statistically significant).2.Blood NLR of AECOPD patients was positively correlated with hs-CRP and WBC count(r=0.292,P=0.003).R=0.334,P=0.001),while NLR has no correlation with RDW(r=-0.09,P=0.376).There was a positive correlation between NLR and WBC count(r=0.208,P=0.038),but no correlation between NLR and hs-CRP or RDW(r=-0.025,P=0.808).R=0.019,P=0.848).3.There was no correlation between RDW,hs-CRP and WBC count in AECOPD patients(r=-0.135,P=0.180).R=0.053,P=0.599).There was no correlation between blood RDW,hs-CRP and WBC count in COPD stable patients(r=0.081,P=0.421).R=0.061,P=0.544).4.The blood NLR value of the respiratory failure group was significantly higher than that of the non-respiratory failure group,and there was a statistical difference(P< 0.05).The blood RDW value of the respiratory failure group was higher than that of the non-respiratory failure group,but there was no statistical difference(P > 0.05).5.Blood NLR level of patients with acute exacerbation of COPD was significantly correlated with hospitalization(r=0.260,P=0.009),while blood RDW level of patients with acute exacerbation of COPD was not significantly correlated with length of hospitalization(r=0.026,P=0.798).6.The area under the curve of acute exacerbation of chronic obstructive pulmonary disease(AUC)diagnosed by NLR was 0.854(95% ci0.799-0.910),with a critical value of 5.22,a sensitivity of 71% and a specificity of 92%.The AUC under the curve of acute exacerbation of chronic obstructive pulmonary disease(RDW)was0.700(95% ci0.624-0.777)with a critical value of 13.45,a sensitivity of 91% and a specificity of 56%.The area under the curve(AUC)for the diagnosis of acute exacerbation of chronic obstructive pulmonary disease(hs-CRP)was 0.804(95%ci0.744-0.864),with a critical value of 9.35,a sensitivity of 72% and a specificity of77%.The area under the curve(0.873),sensitivity and specificity of NLR combined with RDW in the diagnosis of acute exacerbation of COPD were 0.74 and 0.91,respectively.7.The blood NLR of patients with acute exacerbation of chronic obstructive pulmonary disease on admission was significantly correlated with the number of acute exacerbations within 1 year after discharge(r=0.878,P=0).There was no significant correlation between blood RDW at admission of patients with stable COPD and the number of acute exacerbations within 1 year after discharge(r=-0.131,P=0.387).CONCLUSIONS:1.NLR and RDW are valuable for the diagnosis of AECOPD.The higher the NLR and RDW are,the more valuable the diagnosis of AECOPD will be.2.NLR can be used as an indicator for the evaluation and prognosis of AECOPD patients.