摘要
目的评估血小板/淋巴细胞比值(PLR)和中性粒细胞/淋巴细胞比值(NLR)与急性加重期慢性阻塞性肺疾病(AECOPD)住院患者90 d病死率的相关性和预测价值。方法选取2020年11月至2022年6月连续入住我院呼吸内科的AECOPD患者194例作为研究对象。根据患者90 d内是否死亡将患者分为存活组和死亡组。采用单因素分析比较两组PLR、NLR与其他可疑因素的组间差异,单因素分析组间差异有统计学意义的变量纳入Logistic回归模型,考察患者90 d内死亡的独立预测因素。通过受试者工作特征(ROC)曲线分析PLR和NLR预测患者90 d病死率的准确度和敏感度。结果18例(9.3%)患者在出院后90 d内死亡。单因素分析结果显示,年龄、血红蛋白、中性粒细胞计数、COPD综合分级、PaCO_(2)、NLR和PLR与90 d内死亡具有相关性。多因素Logistic回归分析表明,只有PLR是出院后90 d内死亡的独立影响因素。PLR预测90 d内死亡的ROC曲线下面积(AUC)为0.695,敏感度为63.0%,特异度为74.0%;NLR预测90 d内死亡的AUC为0.723,敏感度为83.1%,特异度为68.3%;PLR+NLR联合预测90 d内死亡的AUC为0.736(95%CI 0.568~0.898),P=0.032,敏感度为83.6%,特异度为73.8%。结论PLR和NLR可以作为一种简单、经济的外周血标志物来反映COPD患者特别是在急性加重期时的炎症严重程度,联合检测可以预测AECOPD患者90 d病死率。
Objective To evaluate the correlation and predictive value of platelet/lymphocyte ratio(PLR)and neutrophil/lymphocyte ratio(NLR)with acute exacerbation chronic obstructive pulmonary disease(AECOPD)inpatient mortality within 90 days.Methods 194 AECOPD patients admitted to the department of respiratory medicine of our hospital from November 2020 to June 2022 were selected as the study subjects.Patients were divided into survival group and death group according to whether they died within 90 days.Univariate analysis was used to compare the differences of PLR,NLR and other suspicious factors.Variables with statistically significant differences between univariate analysis groups were included in the Logistic regression model to investigate the independent predictors of death within 90 days.The accuracy and sensitivity of PLR and NLR in predicting 90-day mortality were analyzed by using the receiver operating characteristic(ROC)curve.Results Eighteen patients(9.3%)died within 90 days of discharge.Univariate analysis showed that age,hemoglobin,neutrophil count,COPD composite grade,PaCO_(2),NLR and PLR were associated with 90-day death.Multivariate Logistic regression analysis showed that only PLR were independent risk factors for death within 90 days after discharge.The area under ROC curve(AUC)of PLR for predicting 90-day death was 0.695,the sensitivity was 63.0%,and the specificity was 74.0%.The AUC of NLR for predicting 90-day death was 0.723,the sensitivity was 83.1%,and the specificity was 68.3%.The AUC of PLR+NLR combined prediction of 90-day death was 0.736(95%CI 0.568-0.898),P=0.032,with a sensitivity of 83.6%and specificity of 73.8%.Conclusions PLR and NLR can be used as a simple and cheap peripheral blood marker to reflect the severity of inflammation in patients with COPD,especially in acute exacerbation.The combined detection of PLR and NLR can predict the 90-day mortality of AECOPD patients.
作者
冯思鹏
李梦远
李隆祥
Feng Si-peng;Li Meng-yuan;Li Long-xiang(Department of Respiratory Medicine,Taizhou Municipal Hospital,Taizhou 318000,China)
出处
《中国急救医学》
CAS
CSCD
2022年第9期764-768,共5页
Chinese Journal of Critical Care Medicine
作者简介
冯思鹏(1993-),男,住院医师,E-mail:feng13736568414@163.com;通信作者:李隆祥(1965-),男,主任医师,E-mail:lilongxiang123456@163.com。
