Diagnostic value and correlation analysis of peripheral blood neutrophil-to-lymphocyte ratio and red blood cell distribution width in patients with acute exacerbation of chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 LIU Yuanming , WEN Lu , XIAO Sanling , WANG Rui , LI Lingxue

Department of Respiratory and Critical Care Medicine, People’s Hospital of Pengzhou, Pengzhou, Sichuan 611930, P. R. China;

Corresponding?author：

LIU Yuanming, Email: 158071252@qq.com

Keywords：

Chronic obstructive pulmonary disease; Neutrophil-to-lymphocyte ratio; Red blood cell distribution width; White blood cell count

DOI：

10.7507/1671-6205.202101025

Video：

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Objective To explore the correlation and diagnostic value of neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in peripheral blood of patients with exacerbation of chronic obstructive pulmonary disease (COPD). Methods One hundred patients with acute exacerbation of COPD who were hospitalized in the hospital between January 2019 and October 2020 were selected as exacerbation group, and another 100 patients with stable COPD who received treatment during the same time period were enrolled as stable group. The general data of patients were collected, and blood samples were collected to detect hemoglobin (Hb), platelet count (PLT), white blood cell count (WBC), neutrophil count, lymphocyte count and RDW, and the NLR was calculated. The correlation between the detection indicators was analyzed and receiver operating characteristic (ROC) curve was drawn to analyze the detection significance of related indicators. Results There were no statistical differences in the levels of Hb and PLT between the exacerbation group and the stable group (P>0.05). The levels of WBC, NLR, RDW and high-sensitivity C-reactive protein (hs-CRP) in the exacerbation group were significantly higher than those in the stable group (all P<0.05). NLR in the patients with acute exacerbation of COPD was positively correlated with serological indicators of WBC and hs-CRP (all P<0.05). ROC curve showed that the sensitivity and specificity of NLR in the diagnosis of acute exacerbation of COPD were 92.0% and 68.0% respectively, those of RDW were 91.0% and 58.0% respectively, those of hs-CRP were 77.0% and 71.0% respectively, and those of NLR+RDW were 90.0% and 73.0% respectively. NLR had the highest diagnostic specificity, RDW had the highest diagnostic sensitivity, and NLR+RDW had the best diagnostic efficiency. Conclusions Serological indicators of WBC, hs-CRP, NLR and RDW in patients with acute exacerbation of COPD will be abnormally increased, and NLR has a positive correlation with WBC and hs-CRP. NLR and RDW have high specificity and high sensitivity respectively in the diagnosis of patients with exacerbation of COPD, and their detection can strengthen the diagnosis and mastery of disease in patients.

Citation： LIU Yuanming, WEN Lu, XIAO Sanling, WANG Rui, LI Lingxue. Diagnostic value and correlation analysis of peripheral blood neutrophil-to-lymphocyte ratio and red blood cell distribution width in patients with acute exacerbation of chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(12): 842-845. doi: 10.7507/1671-6205.202101025 Copy

1.	李四香, 趙爽, 李為民. 中性粒細胞與淋巴細胞比值在慢性阻塞性肺疾病中的應用研究進展. 中國呼吸與危重監護雜志, 2020, 19(3): 304-308.
2.	孫峰, 燕存子, 夏宇, 等. 不伴紅細胞增多的慢性阻塞性肺疾病患者并發肺栓塞的影響因素研究. 中國全科醫學, 2020, 23(24): 3018-3022.
3.	楊仲岳, 陳曉梅, 石亞妹, 等. 中性粒細胞/淋巴細胞、血小板/淋巴細胞比值在類風濕關節炎中的研究進展. 中華醫學雜志, 2020, 100(47): 3818-3820.
4.	汪二剛, 趙成嶺, 邵傳利, 等. 慢性阻塞性肺疾病炎癥和過敏性指標的分析和應用. 中國臨床研究, 2019, 32(11): 57-60.
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6.	高潔, 羅玫, 馬唯. 妊娠期高血壓疾病患者孕早期外周血中性粒細胞、單核細胞與淋巴細胞比值的觀察. 中華全科醫師雜志, 2019, 18(9): 851-855.
7.	路明, 姚婉貞. 2019年版慢性阻塞性肺疾病全球創議主要更新內容解讀(非藥物治療篇). 中華結核和呼吸雜志, 2019, 42(3): 238-240,192.
8.	王明航, 畢麗嬋, 殷露艷, 等. 慢性阻塞性肺疾病急性加重早期識別工具的應用. 中國老年學雜志, 2021, 41(10): 2216-2219.
9.	Yoshitomi R, Nakayama M, Sakoh T, et al. High neutrophil/lymphocyte ratio is associated with poor renal outcomes in Japanese patients with chronic kidney disease. Renal Failure, 2019, 41(1): 238-243.
10.	錢俊峰, 金元虹, 王洪源. 咽喉反流、炎癥因子與慢性阻塞性肺疾病急性加重的相關性研究. 中國現代醫學雜志, 2019, 29(8): 99-102.
11.	Sakurai K, Chubachi S, Irie H, et al. Clinical utility of blood neutrophil-lymphocyte ratio in Japanese COPD patients. BMC Pulmon Med, 2018, 18(1): 65-66.
12.	周凌, 蔣丕萍. 外周血中性粒細胞與淋巴細胞比值在急性呼吸窘迫綜合征中的臨床價值. 中國免疫學雜志, 2019, 35(2): 223-226,229.
13.	黃瑋瑋, 曾帆, 盧森, 等. 紅細胞分布寬度對體外膜肺氧合患者預后的評估價值. 中華急診醫學雜志, 2021, 30(6): 723-729.
14.	孟婕, 王曉陽, 李肖肖, 等. 紅細胞分布寬度與持續不臥床腹膜透析患者死亡的相關性. 中華腎臟病雜志, 2018, 34(2): 87-93.
15.	Ghazizadeh H, Mirinezhad MR, Seyedi SMR, et al. Prognostic factors associating with pro-oxidant-antioxidant balance; neutrophils to lymphocytes ratio, vitamin D, heat shock protein 27, and red cell distribution width. Arch Med Res, 2020, 51(3): 261-267.
16.	朱春明, 張鶴, 鄭銳. 中性粒細胞/淋巴細胞比值、紅細胞分布寬度與慢性阻塞性肺疾病急性加重的相關分析. 中國醫科大學學報, 2018, 47(4): 312-315.

1. 李四香, 趙爽, 李為民. 中性粒細胞與淋巴細胞比值在慢性阻塞性肺疾病中的應用研究進展. 中國呼吸與危重監護雜志, 2020, 19(3): 304-308.
2. 孫峰, 燕存子, 夏宇, 等. 不伴紅細胞增多的慢性阻塞性肺疾病患者并發肺栓塞的影響因素研究. 中國全科醫學, 2020, 23(24): 3018-3022.
3. 楊仲岳, 陳曉梅, 石亞妹, 等. 中性粒細胞/淋巴細胞、血小板/淋巴細胞比值在類風濕關節炎中的研究進展. 中華醫學雜志, 2020, 100(47): 3818-3820.
4. 汪二剛, 趙成嶺, 邵傳利, 等. 慢性阻塞性肺疾病炎癥和過敏性指標的分析和應用. 中國臨床研究, 2019, 32(11): 57-60.
5. Mirza S, Clay RD, Koslow MA, et al. COPD Guidelines: A Review of the 2018 GOLD Report. Mayo Clin Proc, 2018, 93(10): 1488-1502.
6. 高潔, 羅玫, 馬唯. 妊娠期高血壓疾病患者孕早期外周血中性粒細胞、單核細胞與淋巴細胞比值的觀察. 中華全科醫師雜志, 2019, 18(9): 851-855.
7. 路明, 姚婉貞. 2019年版慢性阻塞性肺疾病全球創議主要更新內容解讀(非藥物治療篇). 中華結核和呼吸雜志, 2019, 42(3): 238-240,192.
8. 王明航, 畢麗嬋, 殷露艷, 等. 慢性阻塞性肺疾病急性加重早期識別工具的應用. 中國老年學雜志, 2021, 41(10): 2216-2219.
9. Yoshitomi R, Nakayama M, Sakoh T, et al. High neutrophil/lymphocyte ratio is associated with poor renal outcomes in Japanese patients with chronic kidney disease. Renal Failure, 2019, 41(1): 238-243.
10. 錢俊峰, 金元虹, 王洪源. 咽喉反流、炎癥因子與慢性阻塞性肺疾病急性加重的相關性研究. 中國現代醫學雜志, 2019, 29(8): 99-102.
11. Sakurai K, Chubachi S, Irie H, et al. Clinical utility of blood neutrophil-lymphocyte ratio in Japanese COPD patients. BMC Pulmon Med, 2018, 18(1): 65-66.
12. 周凌, 蔣丕萍. 外周血中性粒細胞與淋巴細胞比值在急性呼吸窘迫綜合征中的臨床價值. 中國免疫學雜志, 2019, 35(2): 223-226,229.
13. 黃瑋瑋, 曾帆, 盧森, 等. 紅細胞分布寬度對體外膜肺氧合患者預后的評估價值. 中華急診醫學雜志, 2021, 30(6): 723-729.
14. 孟婕, 王曉陽, 李肖肖, 等. 紅細胞分布寬度與持續不臥床腹膜透析患者死亡的相關性. 中華腎臟病雜志, 2018, 34(2): 87-93.
15. Ghazizadeh H, Mirinezhad MR, Seyedi SMR, et al. Prognostic factors associating with pro-oxidant-antioxidant balance; neutrophils to lymphocytes ratio, vitamin D, heat shock protein 27, and red cell distribution width. Arch Med Res, 2020, 51(3): 261-267.
16. 朱春明, 張鶴, 鄭銳. 中性粒細胞/淋巴細胞比值、紅細胞分布寬度與慢性阻塞性肺疾病急性加重的相關分析. 中國醫科大學學報, 2018, 47(4): 312-315.

Chinese Journal of Respiratory and Critical Care Medicine

Diagnostic value and correlation analysis of peripheral blood neutrophil-to-lymphocyte ratio and red blood cell distribution width in patients with acute exacerbation of chronic obstructive pulmonary disease

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