Application Value Of Blood NLR?cysC?Hs-CRP And ESR Level In Chronic Obstructive Pulmonary Disease

Objective: 1.To study the relationship between neutrophil to lymphocyte ratio(NLR),cystatinC(CysC),hypersensitive C-reactive protein(Hs-CRP),erythrocyte sedimentation rate(ESR)and chronic obstructive pulmonary disease(COPD);2.To investigate the value of Hs-CRP,ESR,NLR and CysC in acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods: 1.Selecting 169 AECOPD patients in Yinchuan first people's hospital from May 2018 to December 2019 as AECOPD group,133 stable COPD patients concurrently as COPD group,and 122 healthy checkup patients during the same period as control group and collecting clinical data from all subjects.And then analyzing the differences and the correlation in peripheral blood NLR,CysC,Hs-CRP,ESR among the three groups;2.Subdividing AECOPD group and COPD group into mild group(GOLD?-?)and severe group(GOLD?-?)according to lung function grade,continuing to contrast the differences of blood NLR,CysC,Hs-CRP and ESR among the subgroups;3.Using receiver operating characteristic(ROC)curves to evaluate the diagnostic value of the indicators above for AECOPD;4.Dividing AECOPD patients into the remission discharge group and the non-remission discharge group according to the treatment outcome and analyzing the differences of blood NLR,CysC,Hs-CRP and ESR between the two groups.Results:1.Hs-CRP and ESR in peripheral blood of AECOPD group weresignificantly higher than those in COPD group(P<0.05);Hs-CRP,ESR,NLR and CysC in AECOPD group and COPD group were significantly higher than those in control group(P<0.05).2.Hs-CRP and NLR in the severe COPD group were higher than those in the mild group(P<0.05).3.Correlation analysis showed that Hs-CRP was positively correlated with ESR,NLR and CysC,and negatively correlated with FEV1 and FEV1/FVC(P<0.05).4.The ROC curve shows the diagnostic efficacy of each observation index on AECOD.NLR: AUC was 0.754,critical value was 2.45,sensitivity was 56%,and specificity was 83.1%;CysC: AUC was 0.819,critical value was 0.875,sensitivity was 78%,and specificity was 76.9%;Hs-CRP: AUC was 0.932,critical value was2.835,sensitivity was 81.6%,and specificity was 98.5%;ESR: AUC was 0.862,critical value was 15.5,sensitivity was 65.2%,and specificity was 94.6%;As for the four indicators combined,the AUC was 0.984,sensitivity was 92.2% and specificity was 98.5% respectively.5.In AECOPD patients,the blood NLR,Hs-CRP and ESR of the nonremission discharge group were significantly higher than that of the remission discharge group(P< 0.05).Conclusion:1.NLR,CysC,Hs-CRP and ESR are all inflammation indicators related to COPD.Among them,NLR and Hs-CRP can indirectly reflect the severity of airflow restriction in COPD patients.2.The combined detection of NLR,CysC,Hs-CRP,and ESR have higher sensitivity and specificity in the diagnosis of AECOPD,which can be used for diagnosis of AECOPD.3.NLR and Hs-CRP can be used as reference indexes for the treatment outcome of AECOPD patients.