Correlation Of Peripheral Blood NLR,BNP And D-dimer To Lower Limb Venous Thrombosis In Patients With AECOPD

Research objective: To investigate the correlation between peripheral blood neutrophil/lymphocyte ratio(NLR),BNP,D-dimer and lower extremity venous thrombosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Research methods: 1432 patients with AECOPD were selected from the Department of Respiratory and Critical Care Medicine,Xianyang Hospital,Yan’an University from January 2017 to January 2022.After screening by inclusion criteria and exclusion criteria,1189 patients were excluded,243 patients were finally determined to be included.According to whether they were complicated with lower limb venous thrombosis,they were divided into AECOPD group of 130 patients and AECOPD combined with thrombosis group of 113 patients.The basic data of patients(gender,age,height,weight,previous smoking history),clinical laboratory data(blood routine,inflammation index,blood biochemistry,blood gas analysis,D-dimer,BNP and coagulation function)and imaging data(color Doppler ultrasound of blood vessels in both lower limbs)were collected respectively.SPSS 26.0 statistical software was used for statistical analysis.For measurement data conforming to normal distribution,the mean ± standard deviation±s),and make test of two independent samples for these measurement data;For the measurement data of non-normal distribution,the median(interquartile interval)[M(P25～P75)] is described,and the nonparametric rank sum test(Mann-Whitney U test)of two independent samples is performed;The counting data was described by the number of cases(rate),and the correlation analysis was performed by Sperman analysis.The difference was statistically significant with P<0.05.Multivariate logistic regression analysis was used to evaluate the risk factors of lower extremity venous thrombosis in AECOPD patients,and the OR value and 95% confidence interval(CI)were further calculated.At the same time,the receiver operating characteristic(ROC)curve was constructed to evaluate the predictive value of various influencing factors on the occurrence of lower limb venous thrombosis in AECOPD patients,and the area under each curve(AUC value)was calculated at the same time.The difference was statistically significant with P<0.05.Research results:1.Comparison of basic data between the lower extremity venous thrombosis group and the non-lower extremity venous thrombosis group: age,smoking history and BMI were statistically different(P<0.05).There was no significant difference in gender between the AECOPD group with lower limb thrombus and the AECOPD group without thrombus.2.Comparison of clinical data between the lower extremity venous thrombosis group and the non-lower extremity venous thrombosis group: HCT,LC,NLR,PLR,RDW,FPG,TG,BNP,Pa O2,APTT,FDP,D-D in the AECOPD group with lower extremity thrombosis were higher than those in the AECOPD group without lower extremity thrombosis(P<0.05).There was no statistical difference between NC,PLT,TC,PH and Pa CO2.3.Multivariate regression results showed that BMI,smoking,age,NLR,D-D,TG,BNP were independent risk factors for lower extremity venous thrombosis in AECOPD patients(P<0.05).The age OR value was 1.112(95%CI:1.059-1.167).BMI OR =1.183(95%CI:1.06-1.322);OR of smoking history was 2.288(95%CI:1.04-5.036);NLR OR value was 1.105(95%CI:1.003-1.218);D-dimer OR = 2.428(95%CI:1.317-4.474);BNP OR = 1.001(95%CI:1.000-1.001);TG OR = 2.951(95%CI:1.451-6.002)4.Correlation analysis of risk factors in AECOPD patients: Age(r=0.463,P<0.005),BMI(r=0.160,P<0.005),smoking(r=0.188,P<0.005),NLR(r=0.231,P<0.005),D-D(r=0.456,P<0.005),BNP(r=0.504,P<0.005),P<0.005),TG(r=0.157,P<0.005)was positively correlated with the occurrence of lower extremity venous thrombosis.5.ROC curve was constructed to evaluate the diagnostic efficacy of each index for AECOPD combined with lower extremity venous thrombosis.The results showed that the AUC value of BMI was 0.593,the sensitivity was 69.9%,and the specificity was 50.0%.The AUC value of NLR was 0.634,the sensitivity was 75.2%,and the specificity was52.3%.The AUC value of D-D was 0.764,the sensitivity was 62.8%,and the specificity was 84.6%.TG AUC value was 0.591,sensitivity was 54.9%,specificity was 65.4%;The AUC value of BNP was 0.792,the sensitivity was 74.2%,and the specificity was 73.1%.The above indicators have good predictive power in predicting VTE events in AECOPD patientsResearch conclusion:1.NLR,BNP and D-dimer were independent risk factors for lower limb venous thrombosis in patients with AECOPD.2.NLR,BNP and D-dimer are positively correlated with lower extremity venous thrombosis in patients with AECOPD,which can be used as important monitoring indicators of lower extremity venous thrombosis in patients with AECOPD,and the predictive efficacy of BNP and D-D is better than NLR.