The Application Value Of RDW,ELR And MLR In Acute Asthma

Objective:The purpose of this study was to investigate the expression levels and clinical significance of RDW,ELR and MLR in patients with acute asthma.Methods:90 cases of acute asthma patients admitted to the department of respiratory and critical care medicine of the First Hospital of Shanxi Medical University from January2018 to October 2019 were selected as the asthma group,and 60 cases of healthy people who underwent physical examination at the same time were selected as the control group.Basic data and admission blood routine were collected to compare the differences of RDW,ELR and MLR between the two groups.Further according to the illness severity of asthma patients divided into light,medium,heavy three groups,according to the classification of induced sputum cytology counts,divided into acidophilic granulocyte（EOS）,neutrophils（NEU）,and mixed cell type（MIX）,fewer cells（PAU）four groups,collect clinical data on lung function,induced sputum,To compare the expression of RDW,ELR and MLR in patients with different severity and phenotype and to explore their relationship with lung function.Results:1.Ninety patients with acute asthma were included as the case group,including 34males and 56 females,aged from 20 to 75 years old,with an average age of（53.38±12.78）years old.A total of 60 healthy patients with matched basic data were selected as the control group,including 20 males and 40 females,aged from 20 to 75 years old,with an average age of（51.06±12.17）years old.2.There was no statistically significant difference between the asthma group and the control group in age,sex,body mass index,smoking rate（P>0.05）.RDW,ELR and MLR in the asthma group were all higher than those in the control group,with statistically significant differences（P<0.05）.3.Grouped according to the severity of the illness:There was no statistically significant difference in age,sex,disease course,body mass index and smoking rate among the light,medium and heavy groups（P>0.05）.FEV₁ and FEV₁/FVC in the severe asthma group were significantly lower than those in the mild and moderate groups,with statistically significant differences（P<0.05）.The levels of RDW,ELR and MLR in the severe asthma group were all higher than those in the mild and moderate groups,with statistically significant differences（P<0.05）.4.In the asthma group,RDW was negatively correlated with FEV₁（r=-0.25,P=0.018）,and RDW was negatively correlated with FEV₁/FVC（r=-0.21,P=0.04）.There was no correlation between ELR and FEV₁ in the asthma group,while there was a negative correlation between ELR and FEV₁/FVC（r=-0.28,P=0.008）.MLR has no correlation with FEV₁ and FEV₁/FVC.5.Grouped according to the inflammatory phenotype:There was no statistically significant difference in age,sex,disease course,smoking rate and BMI among the four phenotypes（P>0.05）.The differences of sputum EOS%,sputum NEU%,blood EOS%and blood NEU%were statistically significant（P<0.05）.The difference of ELR was statistically significant（P<0.05）.ELR was significantly increased in EOS asthma,and the level of ELR in MIX asthma was higher than that in NEU and PAU asthma.Blood EOS%was positively correlated with sputum EOS%（r=0.22,P<0.05）.Blood NEU%was positively correlated with sputum NEU%（r=0.36,P<P=0.0007）.ELR was positively correlated with sputum EOS（r=0.40,P<0.001）.Conclusion:RDW,ELR and MLR all contribute to the diagnosis and assessment of asthma.During the acute attack of asthma,RDW,ELR and MLR all increased.And the higher the levels of RDW,ELR and MLR,the more serious the patient’s condition.RDW and ELR were inversely proportional to lung function.The higher the ELR,the greater the likelihood of eos-type asthma.