Prognostic role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for hospital mortality in patients with AECOPD.
Prognostic role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for hospital mortality in patients with AECOPD.
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DOI：
10.2147/copd.s141760
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发表时间：
2017
影响因子：
2.8
通讯作者：
Tang Z
中科院分区：
文献类型：
--
作者：
Yao C;Liu X;Tang Z
慢性阻塞性肺疾病急性加重（AECOPD）是住院的主要原因之一，并与相当大的死亡率相关，临床医生正在寻找有用且易于获得的生物标志物来进行预后评估。本研究旨在确定中性粒细胞-淋巴细胞比值 (NLR) 和血小板-淋巴细胞比值 (PLR) 作为 AECOPD 患者医院死亡率的预后指标的潜在作用。我们在这项回顾性研究中纳入了 303 名 AECOPD 患者。收集临床特征、NLR、PLR以及血清C反应蛋白（CRP）水平等数据。通过 Pearson 相关性检验评估 NLR/PLR 与 CRP 之间的关系。采用受试者工作特征曲线和曲线下面积（AUC）评估NLR和PLR预测AECOPD患者住院死亡率的能力。所有AECOPD患者的NLR和PLR平均水平分别为7.92±8.79和207.21±148.47。 NLR水平与血清CRP水平相关（r=0.281，P<0.05）。总体住院死亡率为12.21%（37/303）。与 AECOPD 幸存者相比，非幸存者 NLR 和 PLR 水平显着升高（均 P<0.05）。以6.24为临界值，NLR预测医院死亡率的敏感性和特异性分别为81.08%和69.17%，AUC为0.803。以 182.68 为截止点时，PLR 相应的敏感性、特异性和 AUC 分别为 64.86%、58.27% 和 0.639。 NLR、PLR 和 CRP 的组合增加了预后敏感性。 AECOPD 死亡患者的 NLR 和 PLR 水平升高，NLR 可能是 AECOPD 患者医院死亡率的简单且有用的预后标志物。应该进行更多的研究来证实我们的发现。
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is one of the leading causes of hospitalization and is associated with considerable mortality, for which clinicians are seeking useful and easily obtained biomarkers for prognostic evaluation. This study aimed to determine the potential role of the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) as prognostic makers for hospital mortality in patients with AECOPD. We included 303 patients with AECOPD in this retrospective study. Clinical characteristics, NLR, PLR, and serum levels of C-reactive protein (CRP) and other data were collected. Relationships between NLR/PLR and CRP were evaluated by Pearson’s correlation test. Receiver operating characteristics curve and the area under the curve (AUC) were used to assess the ability of NLR and PLR to predict hospital mortality in patients with AECOPD. Mean levels of NLR and PLR of all patients with AECOPD were 7.92±8.79 and 207.21±148.47, respectively. NLR levels correlated with serum CRP levels (r=0.281, P<0.05). The overall hospital mortality rate was 12.21% (37/303). Levels of NLR and PLR were signifi-cantly higher among non-survivors compared to survivors of AECOPD (both P<0.05). At a cut-off value of 6.24, the sensitivity and specificity of the NLR in predicting hospital mortality were 81.08% and 69.17%, respectively, with an AUC of 0.803. At a cut-off of 182.68, the corresponding sensitivity, specificity and AUC of PLR were 64.86%, 58.27%, and 0.639. The combination of NLR, PLR, and CRP increased the prognostic sensitivity. NLR and PLR levels were increased in non-survivor patients with AECOPD, and the NLR may be simple and useful prognostic marker for hospital mortality in patients with AECOPD. More studies should be carried out to confirm our findings.