| BackgroundChronic obstructive pulmonary disease(COPD)is a chronic inflammatory disease of the airways and lungs characterized by chronic infiltration of inflammatory cells such as macrophages,neutrophils and T lymphocytes,and by irreversible airflow limitation.The clinical manifestations of COPD are known to be associated with an increased systemic inflammatory process,and inflammatory markers such as c-reactive protein(CRP)and interleukin 6(IL-6)may be involved in the pathogenesis of the disease and related to its severity.In addition,neutrophils and platelets also play a key role in the inflammatory response and immune mediation.On this basis,we investigated whether these indicators could be applied to predict the risk of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).ObjectiveTo investigate the clinical significance of neutrophil to lymphocyte ratio,platelet to lymphocyte ratio,serum C-reactive protein and interleukin-6 in patients with acute exacerbation of chronic obstructive pulmonary disease and to analyze the relationship between these indexes and the severity of AECOPD and their predictive value.MethodsA total of 160 AECOPD patients admitted to the First Affiliated Hospital of Xinxiang Medical Uniwersity from December 2019 to May 2022 were selected as the study subjects and 80 healthy subjects were selected as the control group.Lymphocyte,platelets and neutrophil absolute count were obtained by measuring serum CRP and IL-6 levels of all the selected patients and completing the blood routine of the subjects absolute value and other indicators.Independent sample T test was performed to compare the serum CRP,IL-6,NLR,PLR levels between the two groups.According to The Global Initiative on Chronic Obstructive Pulmonary Disease,160 patients with acute exacerbation of chronic obstructive pulmonary disease who met the eligibility criteria were enrolled.The GOLD classification was divided into mild to moderate group(GOLD1-2,n=56)and severe recombination group(GOLD3-4,n=104).The serum levels of CRP,IL-6,NLR and PLR were compared between the two groups.Pearson correlation analysis was used to evaluate the correlation between serum CRP,IL-6,NLR,PLR levels and the degree of AECOPD lesions.ROC curve was used to evaluate the diagnostic efficacy of serum CRP,IL-6,NLR and PLR levels for acute exacerbation of chronic obstructive pulmonary disease and its severity.Results(1)There were no significant differences in age,drinking,hypertension,diabetes,sex,lymphocyte,BMI between normal group and AECOPD group(both P>0.05).The values of neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,PLT,NEUT,CRP,WBC and IL-6 in AECOPD group were higher than those in control group(both P<0.05).(2)IL-6,CRP,LYM,PLR,NLR,WBC in mild to moderate AECOPD group were lower than those in heavy polar recombinant IL-6,CRP,LYM,PLR,NLR and WBC(both P<0.05).(3)FEV1 score was negatively correlated with serum CRP,PLR,NLR and IL-6 levels in patients with AECOPD(r=-0.400,r=-0.269,r=-0.288,r=-0.622,both P<0.05).(4)Multifactorial analysis of AECOPD risk factors,PLR OR 1.017(0.977-0.988),NLR OR 1.771(1.256-2.498),IL-6 OR 1.219(1.116-1.333),CRP OR 1.908(1.164-3.126)were found to be AECOPD risk factors.(5)The area under ROC curve of serum IL-6 level in Predictive was 0.854.While the sensitivity was 85.43% and the specificity was 87.5%.The area under ROC curve of serum NLR level in Predictive AECOPD was 0.694.While the sensitivity was73.91% and the specificity was57.5%.ConclusionsThe serum levels of CRP,PLR,IL-6 and NLR in patients with AECOPD are increased,which are independent risk factors for AECOPD.PLR,IL-6 and NLR can be used to evaluate the severity of AECOPD and contribute to the prediction of AECOPD. |
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