Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR) and Monocyte-to-Lymphocyte Ratio (MLR) as Biomarkers in Diagnosis Evaluation of Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective, Observational Study

IF 2.8 3区医学 Q1 Medicine

International Journal of Chronic Obstructive Pulmonary Disease Pub Date : 2024-04-15 DOI:10.2147/copd.s452444

Chuang Cai, Wentan Zeng, Hongwei Wang, Shuqi Ren

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引用次数: 0

Abstract

Purpose: Hierarchical management is advocated in China to effectively manage chronic obstructive pulmonary disease (COPD) patients and reduce the incidence and mortality of acute exacerbation of COPD (AE-COPD). However, primary and community hospitals often have limited access to advanced equipment and technology. Complete blood count (CBC), which is commonly used in these hospitals, offers the advantages of being cost-effective and easily accessible. This study aims to evaluate the significance of routine blood indicators in aiding of diagnosing AE-COPD.
Patients and Methods: In this research, we enrolled a total of 112 patients diagnosed with AE-COPD, 92 patients with stable COPD, and a control group comprising 60 healthy individuals. Clinical characteristics, CBC parameters, and serum CRP levels were collected within two hours. To assess the associations between NLR/PLR/MLR and CRP by Spearman correlation test. The diagnostic accuracy of NLR, PLR and MLR in AE-COPD was assessed using Receiver Operating Characteristic Curve (ROC) and the area under the curve (AUC). Binary Logistic Regression analysis was conducted for the indicators of NLR, PLR and MLR.
Results: We found that patients with AE-COPD had significantly higher levels of NLR, PLR and MLR in contrast to patients with stable COPD. Additionally, the study revealed a noteworthy correlation between CRP and NLR (rs=0.5319, P< 0.001), PLR (rs=0.4424, P< 0.001), and MLR (rs=0.4628, P< 0.001). By utilizing specific cut-off values, the amalgamation of NLR, PLR and MLR augmented diagnostic sensitivity. Binary logistic regression analysis demonstrated that heightened NLR and MLR act as risk factors for the progression of AE-COPD.
Conclusion: The increasing levels of NLR, PLR and MLR could function as biomarkers, akin to CRP, for diagnosis and assessment of acute exacerbations among COPD patients. Further research is required to validate this concept.

Keywords: acute exacerbation of chronic obstructive pulmonary disease, AE-COPD, neutrophil-lymphocyte ratio, NLR, platelet-lymphocyte ratio, PLR, monocyte-lymphocyte ratio, MLR

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中性粒细胞与淋巴细胞比值 (NLR)、血小板与淋巴细胞比值 (PLR) 和单核细胞与淋巴细胞比值 (MLR) 作为诊断评估慢性阻塞性肺病急性加重的生物标志物：一项回顾性观察研究

目的：中国提倡分级管理，以有效管理慢性阻塞性肺疾病（COPD）患者，降低慢性阻塞性肺疾病急性加重（AE-COPD）的发生率和死亡率。然而，基层医院和社区医院往往难以获得先进的设备和技术。这些医院常用的全血细胞计数（CBC）具有成本效益高、容易获得等优点。本研究旨在评估血常规指标在辅助诊断 AE-COPD 方面的意义：本研究共纳入 112 名确诊为 AE-COPD 的患者、92 名慢性阻塞性肺病稳定期患者以及由 60 名健康人组成的对照组。我们在两小时内收集了临床特征、全血细胞计数参数和血清 CRP 水平。通过斯皮尔曼相关性检验评估 NLR/PLR/MLR 与 CRP 之间的关系。采用接收者工作特征曲线（ROC）和曲线下面积（AUC）评估 NLR、PLR 和 MLR 在 AE-COPD 中的诊断准确性。对NLR、PLR和MLR指标进行二元逻辑回归分析：我们发现，AE-COPD 患者的 NLR、PLR 和 MLR 水平明显高于病情稳定的 COPD 患者。此外，研究还发现 CRP 与 NLR（rs=0.5319，P< 0.001）、PLR（rs=0.4424，P< 0.001）和 MLR（rs=0.4628，P< 0.001）之间存在显著的相关性。通过使用特定的临界值，NLR、PLR 和 MLR 的合并提高了诊断灵敏度。二元逻辑回归分析表明，NLR 和 MLR 的升高是 AE-COPD 进展的风险因素：结论：NLR、PLR 和 MLR 水平的升高可作为类似于 CRP 的生物标志物，用于诊断和评估慢性阻塞性肺病患者的急性加重。这一概念还需要进一步研究验证。关键词：慢性阻塞性肺疾病急性加重 AE-COPD；中性粒细胞-淋巴细胞比值 NLR；血小板-淋巴细胞比值 PLR；单核细胞-淋巴细胞比值 MLR

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来源期刊

International Journal of Chronic Obstructive Pulmonary Disease RESPIRATORY SYSTEM-

CiteScore

5.10

自引率

10.70%

发文量

372

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals