| Objective:To investigate the changes of the neutrophil-lymphocyte ratio(NLR),fibrinogen(FIB)and C-reactive protein(CRP)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in order to reveal clinically valuable biomarkers for the diagnosis,condition and prognosis evaluation of AECOPD patients.Methods:80 patients with AECOPD who were hospitalized in the Department of Respiratory Medicine of Xiangxi Autonomous Prefecture People’s Hospital from October 2017 to November 2019 were retrospectively collected.At the same time,80 patients with Chronic Obstructive Pulmonary Disease(SCOPD)who underwent outpatient review during the same period were collected.In addition,80 healthy persons matched in sex and age in the health examination center of our hospital were selected as the healthy control group.The gender,age,neutrophil count(NUE),Lymphocyte count(LMY),FIB,CRP of each group members and results of blood gas analysis,time of admission and discharge,total hospitalization costs of AECOPD group members were collected.Mean±standard deviation(`X±S)was used to represent normal distribution data,and independent sample t-test was used for pairwisecomparison analysis;median(P25,P75)was used to represent skewed distribution data,using Mann-Whitney U test Perform a pairwise comparison analysis,and using the Kruskal-Wallis H test for comparison between multiple groups.Chi-square test was employed to present the counting data;ROC curve was employed to investigate the clinical significance of NLR,FIB and CRP in AECOPD;The correlation between variables were revealed by the spearman method.The above analysis was performed in SPSS 25.0 software,and P<0.05 was considered statistically significant.Results:1.There was no significant difference in gender and age between AECOPD group,SCOPD group and healthy control group.NUE,NLR,FIB,and CRP in the AECOPD group were significantly higher than those in the SCOPD group,while LMY was significantly reduced(P<0.05).In the analysis of ROC curve for the diagnosis of AECOPD,the AUC of NLR was 0.824(95% CI 0.760-0.887),taking 3.65 as the cut-off value,the sensitivity was 83.8%,and the specificity was 67.5%;the AUC of FIB was 0.695(95% CI 0.614-0.776),taking 3.76 as the critical value,the sensitivity was 55.0%,and the specificity was 76.2%;the AUC of CRP was 0.798(95% CI 0.730-0.866),taking 13.78 was the critical value,the sensitivity the 73.8%,and the specificity was 72.5%.2.According to the results of arterial blood gas analysis at the time of admission,80 patients with AECOPD were divided into type IIrespiratory failure group(n=31)and non-type II respiratory failure group(n=49).Compared with the non-type II respiratory failure group,NEU,NLR,and FIB in the type II respiratory failure group increased significantly,while LYM decreased significantly(P<0.05).;the CRP difference between the two groups was not statistically significant(P>0.05).3.Amongst the 80 patients with AECOPD,53 cases were improved and 27 cases were not improved(1 case died,24 cases were discharged automatically,and 2 cases were transferred to other hospitals).Compared with the improved group,the NEU,NLR and FIB of the non-improvement discharge group were significantly increased and the LYM was remarkably decreased(P<0.05).However,no significant difference was shown in CRP between the two groups(P>0.05).4.The NLR(r=0.408,P=0.000)and FIB(r=0.339,P=0.002)of the AECOPD group were positively correlated with the hospital stay,and there was no significant correlation between the hospital stay and CRP(r=0.141,P=0.211).In the AECOPD group,no significant correlation was presented between NLR(r=0.312,P=0.005),FIB(r=0.544,P=0.000)and the hospital costs,and CRP(r=0.168,P=0.136)exhibited no significant correlation with the hospital costs.Conclusions:1.NLR,FIB and CRP are of certain value in the diagnosis of AECOPD.NLR is superior to CRP,and CRP is superior to FIB.2.NLR and FIB have certain value in evaluating the condition and prognosis of AECOPD. |
