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

Objective: the article aims to analyze and compare the white blood cell count(WBC),neutrophil granulocyte count(NEU),lymphocyte count(LYM),and platelet count(PLT),and calculate the ratio of neutrophil granulocyte and lymphocyte(NLR),and the ratio of platelets and Lymphocyte(PLR),to explore its clinical application value in patients with COPD.Methods: From January 2017 to June 2019,the patients who visited a Tertiary hospital in Hefei,Anhui province were included by performing the retrospective study,which were divided into AECOPD group for 141 patients with AECOPD,and SCOPD group for 157 patients with stable COPD who were followed up at the same time during outpatient clinic,and healthy control groups for 50 people without a history of COPD in the health checkup center.It was collected the basic information(gender,age),blood cell count,and CRP among the three groups;It was collected consciousness,chronic health points,body temperature,mean blood pressure,heart rate,respiratory rate,blood gas analysis,blood electrolytes,hepatorenal function,blood routine,hospitalization,with or without the admission in ICU,death status in the AECOPD group within 24 hours,and APACHE? score were calculated.1.It was analyzed whether there was statistical differences in WBC,NLR,PLR,and CRP among the three groups: SCOPD group,AECOPD group,and healthy control group.2.It was analyzed whether there was differences in NLR and PLR between AECOPD combined respiratory failure and non-respiratory failure in the AECOPD group.3.It was analyzed whether there was the correlation between NLR,PLR and CRP in the AECOPD group.4.It was analyzed whether there was statistical differences in clinical indicators such as WBC,NLR,PLR,and CRP between the AECOPD survival group and AECOPD death group.5.The evaluation value of NLR,PLR,APACHE? scores on the risk of death in hospital for AECOPD patients was analyzed by using the receiver operating characteristic curve.6.It was compared the differences in the days of patients hospitalization and ICU occupancy rates in AECOPD groups with high and low NLR and PLR values.Result: 1.The WBC,NLR,PLR,and CRP among the AECOPD group,SCOPD group,and healthy control group were shown as(8.72±3.41,6.34±1.98,5.31±1.26),(10.24±4.01,3.50±1.51,1.24±0.42),(190.85±81.71,124.00±61.06,81.17±24.47),(44.63±17.57,10.53±4.00,2.61±1.15)respectively.With the comparison of WBC,NLR,PLR,and CRP among the three groups,the overall differences of the indicators were statistically significant(P <0.05).Further comparison was shown that WBC,NLR,PLR,and CRP in the SCOPD group were significantly higher than those in the healthy control group(P <0.05),and WBC,NLR,PLR,and CRP in the AECOPD group were significantly higher than those in the SCOPD group and the healthy control group(P <0.05).2.AECOPD group was further divided into respiratory failure group(n = 61 cases)and non-respiratory failure group(80 cases).There was no statistical difference in age and gender between the two groups.The NLR and PLR values in the AECOPD combined respiratory failure group were higher than those in the non-respiratory failure group,with the differences as statistical significance(P <0.05).3.In the AECOPD group,NLR and PLR was shown the significant linear correlation with blood CRP;NLR and CRP was shown the significant positive correlation(r = 0.280,P <0.001);and PLR was shown the significant positive correlation with CRP(r = 0.217,P <0.001).4.WBC,NLR,PLR,CRP(11.56±5.21,12.03±5.11,227.73±90.17,60.15±18.05)in the AECOPD death group were significantly higher than those in the AECOPD survival group(8.30±3.07,9.98±2.37,185±60.15,42.36±15.21),the difference was statistically significant(P <0.05).5.The NLR,PLR,and APACHE? scores were used to predict the risk of death in AECOPD hospitalization.The ROC curve was shown the NLR cutoff value as 11.84(with sensitivity 72.22% and specificity 82.11%),the PLR cutoff value as 210.50(with sensitivity 61.11% and specificity 87.8%),and the cutoff value of APACHE? scores as 25.7 scores(with sensitivity 55.56% and specificity 90.24%),and the risk of death was shown in large.The area under the three joint prediction curves was the largest as 0.892,the corresponding sensitivity was 80.56%,and the specificity was 90.24%.6.According to the NLR and PLR cutoff values,AECOPD patients were divided into two subgroups.The days of hospitalization and ICU occupancy rate in the NLR?11.84 group(n = 35)were significantly higher than those in the NLR<11.84 group(n = 106)with statistical significance in difference(P<0.05);The days of hospitalization,ICU occupancy rate in the PLR ?210.50 group(n = 26)were not significantly different from those in the PLR <210.50 group(P> 0.05).Conclusion: NLR and PLR was correlated with the severity of COPD patients.The assessment in the risk of AECOPD death was valuable,which was the prognostic factors for COPD.The value of NLR in predicting death risk was higher than that of PLR.High NLR was associated with increased hospital stays and increased ICU occupancy rates.It was simple,inexpensive and easy to obtain NLR and PLR,which can be used as effective auxiliary tools on the primary hospitals to manage COPD.