Study On The Correlation Between TCM Syndromes And Prognosis In AECOPD Patients Based On NLR、MLR、PLR And Other Indicators

Objective: By observing and analyzing the correlation between NLR,MLR,PLR and other inflammatory indexes in AECOPD patients and different TCM syndromes and prognosis,to provide a basis for the study of objective indexes of syndrome differentiation treatment of TCM and the evaluation of prognosis of AECOPD patients.Methods: The clinical data of AECOPD patients in respiratory department and geriatrics department of affiliated hospital of Chengdu University of traditional Chinese Medicine from July 1,2019 to December 31,2019 who were passing the inclusion and exclusion criteria were collected.And groups were divided according to different TCM syndromes 、 death and acute exacerbation within 1 year of discharge.The correlation between inflammatory indicators and TCM Syndrome Types 、 prognosis was analyzed by chi-square test and rank test.Spearman rank correlation coefficient was used to study the correlation between pulmonary function grade and prognosis.Receiver Operating Characteristic Curve was used for prognostic value of NLR、MLR、PLR、CRP、ESR in AECOPD patients analysis and Youden index determined the best forecast threshold.Results :1 、 The correlation between different TCM syndromes of AECOPD and related indexes:(1)NLR :syndrome of wind-cold attacking lung<syndrome of external cold internal drink < syndrome of phlegm-heat in the lung / syndrome of phlegm-damp in the lung(P<0.05);(2)MLR: syndrome of wind-cold attacking lung<syndrome of phlegm-heat in the lung / syndrome of phlegm-damp in the lung,syndrome of external cold internal drink<syndrome of phlegm-heat in the lung(P<0.05);(3)PLR:syndrome of wind-cold attacking lung<syndrome of phlegm-heat in the lung / syndrome of phlegm-damp in the lung(P < 0.05);(4)CRP:syndrome of phlegm-heat in the lung > syndrome of wind-cold attacking lung / syndrome of external cold internal drink(P<0.05);(5)ESR:syndrome of wind-cold attacking lung<syndrome of phlegm-heat in the lung(P < 0.05);(6)Patients with acute exacerbation within 1 year of discharge were most phlegm heat obstruction and phlegm dampness obstruction(P<0.05).2、The correlation between death and related indexes during follow-up period:(1)There was a negative correlation between BMI and the number of death(P<0.05).(2)There was no significant difference in hospitalization days、NLR、MLR、PLR、CRP and ESR between the death group and the survival group(P > 0.05).(3)The number of patients with respiratory failure,lung-brain mixture and non-invasive ventilator in death group was higher than that in survival group(P>0.05).(4)There was no significant correlation between lung function grade and death(P<0.05).3、The correlation between acute aggravation and related indexes in AECOPD patients within 1 year of discharge :(1)There was a positive correlation between pulmonary function grade 、 NLR 、 PLR and acute exacerbation within 1 year of discharge(P < 0.05).(2)The predictive value of NLR,PLR,ESR and other inflammatory markers in evaluating acute aggravation of COPD was further discussed,the results of ROC curve showed that NLR、PLR had predictive value for re-admission of COPD patients within one year after discharge,and the best cut-off value and its corresponding sensitivity and specificity were 6.34(46.6%,82.1%),215.6(50%,79.1%).Conclusion:(1)NLR、MLR、PLR、CRP、ESR had certain correlation with different TCM syndromes in AECOPD patients.(2)Patients with acute exacerbation within 1 year of discharge were most phlegm heat obstruction and phlegm dampness obstruction.(3)There was a positive correlation between pulmonary function grade、NLR、PLR and acute exacerbation within 1 year of discharge.(4)NLR、PLR had certain predictive value for the acute exacerbation of AECOPD patients within one year after discharge,and the best critical values were NLR=6.34 and PLR=215.6.