摘要目的 探讨中性粒细胞与淋巴细胞计数比值(NLR)、血小板与淋巴细胞比值(PLR)在慢性阻塞性肺疾病(COPD)中的临床价值,并与C反应蛋白(CRP)进行比较.方法 收集157例明确诊断慢性阻塞性肺疾病急性加重期(AECOPD)住院患者资料,并追踪COPD稳定期(SCOPD)资料;同时抽取146例江苏省人民医院浦口分院同期健康体检人员的临床资料作为参照组.探讨NLR、PLR在预测COPD的急性加重风险中的价值以及与COPD患者肺功能的相关性.结果 (1)与健康对照组和SCOPD组比较,AECOPD组的NLR(H=164.205,P<0.05)、PLR(H=82.467,P<0.05)和CRP(H=181.571,P<0.05)均显著增高.ROC曲线分析显示,CRP敏感度为83.2％,特异度为78.5％;NLR的敏感度为68.3％,特异度为80.5％;PLR的敏感度为60.5％,特异度为71.0％.(2)Ⅰ～ Ⅳ级COPD患者的NLR(H=2.708,P>0.05)、PLR(H=5.614,P>0.05)、CRP(H=3.909,P>0.05)指标差异无统计学意义.结论 NLR、PLR和CRP水平对AECOPD均有较高的诊断价值,NLR与CRP诊断准确性相似.对于NLR、PLR与COPD患者的肺功能严重程度无明显相关性.

abstractsObjective To explore the clinical value of neutrophil-lymphocyte ratio ( NLR) , platelet-lymphocyte ratio ( PLR) in chronic obstructive pulmonary disease ( COPD) ,and compared with C-reactive protein (CRP) .Methods In this study ,the clinical data of 157 patients with clear diagnosis of acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) were enrolled , and their stable period ( SCOPD) data were collected .The clinical data ,which were collected from 146 patients of health examination in Pukou Branch ,Jiangsu Province Hospital ,were randomly taken as the reference group .To explore the value of NLR and PLR in predicting the risk of acute exacerbation of COPD and investigate the correlation between the NLR ,PLR and the lung function of COPD patients .Results (1)Compared with the healthy control group and the SCOPD group ,the NLR ( H =164 .205 , P <0 .05) ,PLR ( H =82 .467 , P <0 .05) ,and CRP ( H =181 .571 , P <0 .05) in the AECOPD group were significantly increased .ROC curve analysis showed that CRP sensitivity was 83 .2％ ,specificity was 78 .5％ .NLR sensitivity was 68 .3％ ,specificity was 80 .5％ . PLR sensitivity was 60 .5％ ,and specificity was 71 .0％ .(2) There was no significant difference in NLR ( H =2 .708 , P >0 .05) ,PLR ( H =5 .614 , P >0 .05) and CRP ( H =3 .909 , P >0 .05)index among patients with Ⅰ-Ⅳ COPD .Conclusions NLR , PLR and CRP levels have high diagnostic value for AECOPD ,and NLR and CRP have similar diagnostic accuracy .There is no significant correlation between lung function severity in patients with NLR ,PLR ,and COPD .