中性粒细胞与淋巴细胞比值、血浆D-二聚体及B型钠尿肽联合检测对慢性阻塞性肺疾病急性加重患者预后的预测意义_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

李宇祺 , 李梁远 , 段昊玙 ,  梁斌苗

四川大学华西医院呼吸与危重症医学科（四川成都 610041）;

Corresponding author：

梁斌苗, Email: liangbinmiao@163.com

Keywords：

慢性阻塞性肺疾病; 急性加重; 中性粒细胞与淋巴细胞比值; 血浆D-二聚体; 血浆 B 型钠尿肽; 预后

DOI：

10.7507/1671-6205.202107078

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探究联合检测中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio，NLR）、血浆 D-二聚体及 B 型钠尿肽（B-type natriuretic peptide，BNP）水平预测慢性阻塞性肺疾病（简称慢阻肺）急性加重期患者预后的价值。方法回顾性分析 2015 年 12 月—2018 年 2 月于四川大学华西医院呼吸与危重症医学科住院治疗的慢阻肺急性加重期患者 565 例，按照住院结局分为好转组（n=469）和未愈或死亡组（n=96），收集患者的基本临床资料和入院 24 h 内 NLR、血浆 D-二聚体及 BNP 检查结果，进行组间比较，分析上述指标单独及联合检测对慢阻肺急性加重患者住院结局的预测效能。结果未愈或死亡组患者 NLR、血浆 D-二聚体、血浆 BNP 水平均显著高于好转组，差异有统计学意义（P<0.05）。在单独预测慢阻肺急性加重患者预后方面，血浆 BNP 水平的曲线下面积最大，为 0.665（P<0.001），血浆D-二聚体的敏感性最高，为73.7%。与单独预测相比，各指标联合预测的曲线下面积提高为 0.681（P<0.001），敏感性提高为 81.1%。结论联合检测NLR、血浆D-二聚体及BNP水平对预测慢阻肺急性加重患者预后有一定的价值，值得在临床上推广。

Citation： 李宇祺, 李梁远, 段昊玙, 梁斌苗. 中性粒细胞与淋巴细胞比值、血浆D-二聚体及B型钠尿肽联合检测对慢性阻塞性肺疾病急性加重患者预后的预测意义. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(6): 432-435. doi: 10.7507/1671-6205.202107078 Copy

1.	Global Initiative for Chronic Obstructive Lung Disease (GOLD): Global Strategy for the Diagnosis, Management and prevention of Chronic Obstructive Pulmonary Disease. (2021 REPORT). Available at: https://goldcopd.org/gold-reports/.
2.	Barbosa MT, Sousa CS, Morais-Almeida M, et al. Telemedicine in COPD: an overview by topics. COPD, 2020, 17(5): 601-617.
3.	Brandsma CA, Van den Berge M, Hackett TL, et al. Recent advances in chronic obstructive pulmonary disease pathogenesis: from disease mechanisms to precision medicine. J Pathol, 2020, 250(5): 624-635.
4.	陶晶, 谢田刚, 栾桂红. 急性加重期慢性阻塞性肺疾病患者血清 ChE、LTB4、BNP 水平变化及临床意义. 山东医药, 2019, 59(22): 8-11.
5.	Ding GZ, Li WS. The expressions and significance of APN, D-D, IL-17 and hs-CRP in patients with acute exacerbation of chronic obstructive pulmonary disease. Eur Rev Med Pharmacol Sci, 2018, 22(19): 6463-6468.
6.	肖光军, 李祥坤, 魏容, 等. 血液中 PLR、NLR 及 D-二聚体水平对 AECOPD 患者的预后价值评估. 检验医学与临床, 2019, 16(8): 1067-1070.
7.	Husebø GR, Gabazza EC, D'Alessandro Gabazza C, et al. Coagulation markers as predictors for clinical events in COPD. Respirology, 2021, 26(4): 342-351.
8.	Teng F, Ye H, Xue TJ. Predictive value of neutrophil to lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary disease. PLoS One, 2018, 13(9): e204377.
9.	王丽芳, 韩寒, 施斌. 红细胞分布宽度联合中性粒细胞/淋巴细胞比值对慢性阻塞性肺疾病急性加重期患者预后的评估价值. 中国医药导报, 2020, 17(35): 34-37.
10.	Aksoy E, Karakurt Z, Gungor S, et al. Neutrophil to lymphocyte ratio is a better indicator of COPD exacerbation severity in neutrophilic endotypes than eosinophilic endotypes. Int J Chron Obstruct Pulmon Dis, 2018, 13: 2721-2730.
11.	El-Gazzar AG, Kamel MH, Elbahnasy O, et al. Prognostic value of platelet and neutrophil to lymphocyte ratio in COPD patients. Expert Rev Respir Med, 2020, 14(1): 111-116.
12.	Luo ZB, Zhang W, Chen LN, et al. Prognostic value of neutrophil: lymphocyte and platelet: lymphocyte ratios for 28-day mortality of patients with AECOPD. Int J Gen Med, 2021, 14: 2839-2848.
13.	Lu FY, Chen R, Li N, et al. Neutrophil-to-lymphocyte ratio predicts clinical outcome of severe acute exacerbation of COPD in frequent exacerbators. Int J Chron Obstruct Pulmon Dis, 2021, 16: 341-349.
14.	Kyriakopoulos C, Gogali A, Kostikas K, et al. Hypercoagulable state in COPD-a comprehensive literature review. Diagnostics (Basel), 2021, 11(8): 1447.
15.	陈金来, 张菊英, 秦红, 等. 血清 D-二聚体水平对预测老年慢性阻塞性肺疾病患者预后的价值. 检验医学, 2021, 36(3): 309-312.
16.	李湘, 罗燕青, 曲雷. D-二聚体水平与慢性阻塞性肺疾病急性加重期预后的关系研究. 国际检验医学杂志, 2018, 39(5): 595-597,601.
17.	Hu GP, Wu Y, Zhou Y, et al. Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2729-2736.
18.	Ruocco G, Evangelista I, Franci B, et al. Combination of ST2 and B-type natriuretic peptide in diabetic patients with acute heart failure: relation with ventricular stiffness and outcome. J Cardiovasc Med (Hagerstown), 2019, 20(2): 81-90.
19.	Amsallem M, Sweatt AJ, Arthur AJ, et al. Targeted proteomics of right heart adaptation to pulmonary arterial hypertension. Eur Respir J, 2021, 57(4): 2002428.
20.	Vallabhajosyula S, Haddad TM, Sundaragiri PR, et al. Role of B-type natriuretic peptide in predicting in-hospital outcomes in acute exacerbation of chronic obstructive pulmonary disease with preserved left ventricular function: a 5-year retrospective analysis. J Intensive Care Med, 2018, 33(11): 635-644.
21.	Li HQ, Zeng Z, Cheng J, et al. Prognostic role of NT-proBNP for in-hospital and 1-year mortality in patients with acute exacerbations of COPD. Int J Chron Obstruct Pulmon Dis, 2020, 15: 57-67.

1. Global Initiative for Chronic Obstructive Lung Disease (GOLD): Global Strategy for the Diagnosis, Management and prevention of Chronic Obstructive Pulmonary Disease. (2021 REPORT). Available at: https://goldcopd.org/gold-reports/.
2. Barbosa MT, Sousa CS, Morais-Almeida M, et al. Telemedicine in COPD: an overview by topics. COPD, 2020, 17(5): 601-617.
3. Brandsma CA, Van den Berge M, Hackett TL, et al. Recent advances in chronic obstructive pulmonary disease pathogenesis: from disease mechanisms to precision medicine. J Pathol, 2020, 250(5): 624-635.
4. 陶晶, 谢田刚, 栾桂红. 急性加重期慢性阻塞性肺疾病患者血清 ChE、LTB4、BNP 水平变化及临床意义. 山东医药, 2019, 59(22): 8-11.
5. Ding GZ, Li WS. The expressions and significance of APN, D-D, IL-17 and hs-CRP in patients with acute exacerbation of chronic obstructive pulmonary disease. Eur Rev Med Pharmacol Sci, 2018, 22(19): 6463-6468.
6. 肖光军, 李祥坤, 魏容, 等. 血液中 PLR、NLR 及 D-二聚体水平对 AECOPD 患者的预后价值评估. 检验医学与临床, 2019, 16(8): 1067-1070.
7. Husebø GR, Gabazza EC, D'Alessandro Gabazza C, et al. Coagulation markers as predictors for clinical events in COPD. Respirology, 2021, 26(4): 342-351.
8. Teng F, Ye H, Xue TJ. Predictive value of neutrophil to lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary disease. PLoS One, 2018, 13(9): e204377.
9. 王丽芳, 韩寒, 施斌. 红细胞分布宽度联合中性粒细胞/淋巴细胞比值对慢性阻塞性肺疾病急性加重期患者预后的评估价值. 中国医药导报, 2020, 17(35): 34-37.
10. Aksoy E, Karakurt Z, Gungor S, et al. Neutrophil to lymphocyte ratio is a better indicator of COPD exacerbation severity in neutrophilic endotypes than eosinophilic endotypes. Int J Chron Obstruct Pulmon Dis, 2018, 13: 2721-2730.
11. El-Gazzar AG, Kamel MH, Elbahnasy O, et al. Prognostic value of platelet and neutrophil to lymphocyte ratio in COPD patients. Expert Rev Respir Med, 2020, 14(1): 111-116.
12. Luo ZB, Zhang W, Chen LN, et al. Prognostic value of neutrophil: lymphocyte and platelet: lymphocyte ratios for 28-day mortality of patients with AECOPD. Int J Gen Med, 2021, 14: 2839-2848.
13. Lu FY, Chen R, Li N, et al. Neutrophil-to-lymphocyte ratio predicts clinical outcome of severe acute exacerbation of COPD in frequent exacerbators. Int J Chron Obstruct Pulmon Dis, 2021, 16: 341-349.
14. Kyriakopoulos C, Gogali A, Kostikas K, et al. Hypercoagulable state in COPD-a comprehensive literature review. Diagnostics (Basel), 2021, 11(8): 1447.
15. 陈金来, 张菊英, 秦红, 等. 血清 D-二聚体水平对预测老年慢性阻塞性肺疾病患者预后的价值. 检验医学, 2021, 36(3): 309-312.
16. 李湘, 罗燕青, 曲雷. D-二聚体水平与慢性阻塞性肺疾病急性加重期预后的关系研究. 国际检验医学杂志, 2018, 39(5): 595-597,601.
17. Hu GP, Wu Y, Zhou Y, et al. Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2729-2736.
18. Ruocco G, Evangelista I, Franci B, et al. Combination of ST2 and B-type natriuretic peptide in diabetic patients with acute heart failure: relation with ventricular stiffness and outcome. J Cardiovasc Med (Hagerstown), 2019, 20(2): 81-90.
19. Amsallem M, Sweatt AJ, Arthur AJ, et al. Targeted proteomics of right heart adaptation to pulmonary arterial hypertension. Eur Respir J, 2021, 57(4): 2002428.
20. Vallabhajosyula S, Haddad TM, Sundaragiri PR, et al. Role of B-type natriuretic peptide in predicting in-hospital outcomes in acute exacerbation of chronic obstructive pulmonary disease with preserved left ventricular function: a 5-year retrospective analysis. J Intensive Care Med, 2018, 33(11): 635-644.
21. Li HQ, Zeng Z, Cheng J, et al. Prognostic role of NT-proBNP for in-hospital and 1-year mortality in patients with acute exacerbations of COPD. Int J Chron Obstruct Pulmon Dis, 2020, 15: 57-67.

Previous Article
MiR-203 targets TLR4 to regulate NF-κB/NLRP3 pathway to protect alveolar epithelial cells from LPS-induced injury
Next Article
恶性颈动脉体瘤肺转移一例并文献复习

Chinese Journal of Respiratory and Critical Care Medicine

中性粒细胞与淋巴细胞比值、血浆D-二聚体及B型钠尿肽联合检测对慢性阻塞性肺疾病急性加重患者预后的预测意义

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content