To Explore The Clinical Value Of Neutrophil To Lymphocyte Ratio And Platelet To Lymphocyte Ratio In Chronic Obstructive Pulmonary Disease

Objective: Severe pneumonia(SP)is the exacerbation of inflammation in lung tissue.With rapid progression and high mortality,Severe pneumonia often leads to multi-organ failure,systemic inflammatory reaction syndrome and sepsis,and seriously threatens the life safety of patients.In this study,the clinical data of SP inpatients were analyzed to investigate the evaluation value of neutrophil/lymphocyte ratio(NLR)for the severity and prognosis of severe pneumonia patients.Methods: A retrospective analysis of the clinical data of 102 patients with severe pneumonia admitted to our hospital from June 2018 to June 2020.According to the acute physiology and chronic health score II(APACHE II)within 24 hours after admission,the patients were divided into two groups: low-medium risk group(APACHE II score ≤20 points)54 cases,high-risk group(APACHE II score>20 Points)48 cases.Collect general data of all patients [age,gender,smoking history,combined underlying diseases,invasive mechanical ventilation time,length of hospital stay,APACHE II score,clinical lung infection severity score(CPIS)] and laboratory index data [white blood cell(WBC),platelet count(PLT),NLR,procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6),blood lactate].Compare general data and laboratory indicators between groups of different severity,and compare general data and laboratory indicators between groups of different prognosis.Spearman correlation was used to analyze the relationship between NLR level and APACHE II score and CPIS score in death group,and ROC curve was used to analyze the predictive value of NLR level on the prognosis of patients with severe pneumonia.Result:1.There were no significant differences in age,gender,smoking history,WBC,and blood lactate among groups with different severity(P> 0.05).2.There were significant differences in the comparison of underlying disease,APACHE II score,CPIS score,PLT,NLR,PCT,CRP,and IL-6 between different severity groups(P <0.05).3.There was no statistically significant difference in age,gender,smoking history,underlying disease,WBC,CRP,and blood lactate among different prognosis groups(P>0.05).4.APACHE II score,CPIS score,PLT,NLR,PCT,IL-6 were compared between different prognosis groups,the difference was statistically significant(P <0.05).5.Spearman correlation analysis showed that the NLR level of the death group was positively correlated with the APACHE II score and CPIS score(r = 0.141,r = 0.201,P<0.05).6.The ROC curve shows that the area under the curve(AUC)of NLR is 0.840(95% CI:0.744 ～ 0.936),the sensitivity is 76.67%,and the specificity is 70.00%(P <0.05).Conclusion:1.NLR level was positively correlated with the severity of severe pneumonia,and the higher NLR value was,the more severe severe pneumonia was.2.NLR level can predict the prognosis of patients with severe pneumonia,and it has good sensitivity and specificity.3.Compared with the classical scoring system and traditional inflammatory markers,NLR is more simple,easy to obtain and less costly,and can be widely used as an auxiliary tool for the clinical diagnosis and treatment of severe pneumonia.