摘要
目的:探讨血小板平均体积(MPV)、中性粒细胞/淋巴细胞比率(NLR)与老年慢性阻塞性肺疾病急性加重(AECOPD)的相关性及近期预后中的临床意义。方法:选取2015年4月至2016年4月收治的52例老年AECOPD患者为研究对象。记录所有患者入院时的MPV、WBC、NC、LC、PLT、CRP、DD、FIB、PaO_2,并记录急性加重期的肺功能指标,计算中性粒细胞/淋巴细胞比率(NLR),于3个月后患者处于COPD稳定期时,门诊复查血常规、凝血全项、CRP、动脉血气及肺功能,52例老年健康体检者为对照组,并进行组间比较,采用Pearson相关分析MPV与WBC、NLR、CRP、DD、FIB、FEV_1%、FEV_1/FVC%的相关性;结果:与COPD稳定期及对照组比较,COPD急性加重期WBC、NLR、DD、FIB及CRP水平升高,FEV_1、FVC、FEV_1%、FEV_1/FVC%降低,MPV水平在急性加重期明显降低。MPV<8.35fl作为分界点预测COPD的急性加重,敏感性约为84.6%,特异性约为86.5%;COPD急性加重期MPV降低与白细胞计数、中性粒细胞/淋巴细胞比率、CRP、DD及FIB增高相关。结论:MPV及NLR可作为老年COPD病情评估的潜在炎症指标,监测MPV水平可能对于预测老年COPD患者的急性加重风险有一定临床意义。
Objective To explore the association of mean platelet volume and neutrophil to lymphocyte ratio with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） in elderly patients and its clinical value for the short-term prognosis. Methods A total of 52 patients with AECOPD who had been hospitalized during the period of April 2014 to April 2015 were enrolled in this prospective observational study. Levels of mean platelet volume （MVP）, C-reactive protein, complete blood count, D-dimer, fibrinogen, percent-of-predicted FEV1 and percent-of＇- predicted FEV1/FVC were measured at admission （acute exacerbation） and after 3 months （stable period）. Fifty-two age- and sex-matched healthy individuals constituted the control group. Pearson＇s correlation was used to analyze the association of MPV with WBC, NLR, CRP, DD, FIB, FEVI%, and FEV1/FVC%. Results In AECOPD, as compared with stable COPD and the control group, levels of WBC, NLR, D-dimer, fibrinogen and CRP elevated; FEV1, FVC, percent-of-predicted FEVI and percent-of-predicted FEV1/FVC declined; and MPV level decreased obviously. As a cut-off point of MVP level of 〈 8.35fl for predicting AECOPD, it showed a sensitivity of 84.6% and a specificity of 86.5%. A decreased MVP level was significantly correlated with an increased in white blood cell count, neutrophil to lymphocyte ratio, D-dimer, fibrinogen and C-reactive protein level （P = 0.01, 0.02, 0.01, 0.02, and 0.O1 respectively）. Conclusions Mean platelet volume and neutrophil to lymphocyte ratio may be inflammatory markers inAE COPD, and measurement of mean platelet volume level may be useful for identifying elderly patients at increased risks for acute exacerbation.
出处
《实用医学杂志》
CAS
北大核心
2017年第6期928-932,共5页
The Journal of Practical Medicine
作者简介
通信作者：李月川E-mail：liyuechuandoctor@126．com
