Study On The Relationship Between The Changes Of Blood Cells And The Acute Attack Of Asthma In Children

Objective:To investigate the clinical diagnostic value of blood cell related changes in children with acute asthma attack and severity of asthma.Methods:Retrospective collection of blood routine and pulmonary function of hospitalized children with acute asthma attack during 2020,In the asthma group（86 cases）,And according to the severity of the disease is divided into severe group（59 cases）,non-severe group（27 cases）;The blood routine results of healthy children were collected as control group.Blood routine neutrophil（NEU）、eosinophils（EOS）、lymphocytes（LYM）、neutrophil-lymphocyte ratio（NLR）、eosinophil-lymphocyte ratio（ELR）and lymphocyte-monocyte ratio（LMR）and Intergroup comparisons,Draw a ROC curve to evaluate the value of these indicators in the diagnosis of acute asthma attacks and severe asthma,The NEU、EOS、LYM、NLR、ELR、LMR and one-second forced expiratory volume（FEV₁）were determined in asthma group.Results:1.Comparison of blood routine NEU,EOS,LYM counts（×10⁹/L）:a.NEU,EOS,LYM counts in the asthma group were 7.01±3.83,0.45±0.42,2.23±1.03,and the NEU,EOS,and LYM counts in control group were respectively 3.67±0.81,0.15±0.08,2.66±0.68.Compared with the control group,the NEU and EOS counts of the asthma group were significantly higher than those of the control group,and the LYM counts were lower than those of the control group.The differences were statistically significant（t=-7.916,P<0.001;t=-6.515,P<0.001;t=3.193,P<0.05）;b.The counts of NEU,EOS and LYM in the severe group were respectively 8.20±3.70,0.45±0.45,2.10±1.07,and the non-critical group were 4.42±2.69,0.44±0.35,2.53±0.87,the comparison between the two groups showed that the NEU of the severe group was significantly increased,and the results were statistically different（t=4.758,P<0.001）.2.Comparison comparison of blood routine NLR、ELR、LMR:a.NLR,ELR,LMR of asthma group were 4.74±4.98,0.20±0.17,4.13±2.51,control group were1.43±0.32,0.06±0.03,6.42±2.06,NLR,ELR of asthma group were significantly higher than that of the control group,while the LMR was lower than the control group.The difference was statistically significant（t=-6.145,P<0.001;t=-8.007,P<0.001;t=6.538,P<0.001）;b.The counts of NLR,ELR,and LMR in the severe group were 5.89±5.47,0.21±0.17,3.62±2.39,respectively,and in the non-critical group were 2.21±2.19,0.19±0.16,5.24±2.44,The comparison showed that NLR was significantly increased in the severe group,while LMR was significantly decreased,and the differences were statistically significant（t=3.367,P<0.001;t=-2.885,P<0.05）.3.Analysis of the ROC curve of NLR,ELR and LMR in evaluating the value of predicting asthma:The best cut-off value of NLR is 1.922,and the sensitivity,specificity and AUC value of predicting asthma are 0.593,0.977 and 0.713（95%CI:0.628-0.798,P<0.001）;the best cut-off value of ELR is 0.109,the sensitivity,specificity and AUC value of predicting asthma are 0.593,1.000 and 0.771respectively（95%CI:0.691-0.850,P<0.001）;LMR The best cut-off value is 3.891,and the sensitivity,specificity and AUC value of predicting asthma are 0.593,0.965and 0.783 respectively（95%CI:0.710-0.855,P<0.001）.The results showed that NLR,ELR,and LMR all have predictive value,and LMR has the highest predictive value for asthma.4.The analysis of the ROC curve of NLR,ELR and LMR in evaluating the value of predicting severe asthma:the best cut-off value of NLR is 2.551,and the sensitivity,specificity and AUC value of predicting asthma are 0.695,0.778 and 0.773respectively（95%CI:0.666-0.879,P<0.001）;the best cut-off value of LMR is 4.391,the sensitivity,specificity and AUC value of predicting asthma are 0.746,0.667 and0.710 respectively（95%CI:0.590-0.830,P<0.05）,and ELR has no predictive value for severe asthma.Among them,NLR has the greatest predictive value for the diagnosis of severe asthma.5.Correlation analysis between NEU,EOS,LYM,NLR,ELR,LMR and FEV₁in asthma group:It was found that NEU,EOS,NLR,ELR and FEV₁were negatively correlated,and the correlation coefficients were（r=-0.491,P<0.001）,（r=-0.329,P<0.05）,（r=-0.398,P<0.05）,（r=-0.486,P<0.001）,and there is no correlation with LYM and LMR.Conclusion:1.Significant changes in blood NEU,EOS,LYM counts and NLR,ELR,and LMR during an acute attack of childhood asthma.NLR,ELR,and LMR have a preliminary predictive effect on the acute attack of childhood asthma,while NLR predicts the acute and severe attack of childhood asthma The most valuable;2.Through NEU,EOS,NLR,ELR values,the changes in lung function FEV₁can be estimated,which can help clinical judgments of the severity of acute asthma attacks,so as to better guide treatment.