| Objective:The purpose of this study was to investigate the relationship between neutrophil/lymphocyte ratio((Neutrophils to lymphocytes ratio,NLR),platelet/lymphocyte ratio((Platelet to lymphocyte ratio,PLR),lymphatic cell/monocyte ratio((Lymphocyte to monocyte ratio,LMR)and pulmonary embolism(Pulmonary embolism,PE)in patients with acute exacerbation of chronic obstructive pulmonary disease((Acute Exacerbation of Chronic Obstructive Pulmonary Dsease,AECOPD).Provide a simple and inexpensive diagnostic tool for clinical practice to help identify PE patients in AECOPD.Methods:We conducted a retrospective case-control study on patients with AECOPD complicated with PE and patients with simple AECOPD in the Department of Respiratory Department of the second affiliated Hospital of Kunming Medical University from January 2015 to December 2019.The clinical data were recorded,including demographic characteristics,vital signs,complications,imaging examination and laboratory examination results.Laboratory indicators included red neutrophil count,lymphocyte count,monocyte count,platelet count and D-dimer and so on.The indicators with statistical significance between groups were included in univariate logistics regression analysis,and then the indicators with statistical differences in univariate analysis were analyzed by multivariate logistics regression analysis to identify the independent risk factors of AECOPD patients complicated with PE,and draw the(ROC)curve of subjects’ working characteristics,and calculate the area(AUC)under the curve to evaluate the predictive value of each index.Results:1.This study included 135 patients with AECOPD complicated with PE and 65 patients with simple AECOPD.There was no significant difference in sex,age,BMI,years of smoking,course of COPD,complications and vital signs between the two groups(P>0.05).2.In the comparison of laboratory indexes between groups,NLR,PLR,ALT,AST,IL-6,RDW-CV,RDW-SD,DD and FIB in AECOPD complicated with PE group were significantly higher than those in simple AECOPD group,and the difference was statistically significant(P<0.05).The LMR in);AECOPD complicated with PE group was significantly lower than that in AECOPD group,but there was no significant difference in other laboratory indexes.Multivariate logistic regression analysis showed that NLR,PLR and DD were independent risk factors for PE complication in patients with AECOPD,with OR values of 1.185,1.005 and 1.217,respectively.LMR was a protective factor for PE complication in patients with AECOPD,with OR value of 0.648.3.ROC curve analysis showed that the AUC values of NLR,PLR,LMR and DD for predicting PE in patients with AECOPD were 0.653,0.709,0.727 and 0.606,respectively,and the best critical values were 6.715,249.250,2.215 and 5.775,respectively.Its sensitivity and specificity were 57.8%and 69.2%,53.3%and 84.6%,80%and 57%,85.4%and 48.1%,respectively.The AUC values of NLR+DD,PLR+DD,LMR+DD and NLR+PLR+LMR+DD for predicting PE in AECOPD patients were 0.717,0.757,0.774 and 0.804,respectively,and the best critical values were 0.758,0.671,0.647 and 0.666.The sensitivity and specificity were 41.5%and 93.8%,63%and 81.5%,72.6%and 76.9%,73.3%and 80%,respectively.Conclusions:1.NLR,PLR and DD were independent risk factors for PE complication in AECOPD patients,and LMR was a protective factor for PE complication in AECOPD patients.2.The combined prediction of NLR,PLR and DD is helpful to improve the diagnostic efficiency of AECOPD patients complicated with PE,and the three combined tests are better than the single prediction of each indicator. |
