中性粒细胞与淋巴细胞比值和支气管扩张症急性加重期严重程度的相关分析

目的 探讨中性粒细胞与淋巴细胞比值(NLR)与支气管扩张症(支扩症)急性加重期严重程度的相关性 。方法 回顾性分析2016年1月—2019年4月在本院呼吸科住院治疗的支扩症患者481例,纳入符合入组条件的191例,其中男性75例,女性116例,年龄17～86岁,平均(59.23±13.34)岁。分析NLR、血红蛋白(HB)、血小板与淋巴细胞比值(PLR)、C反应蛋白(CRP)和支气管扩张严重程度(bronchiectasis severity index,BSI)以及FAECD积分的相关性;用多重线性回归分析法分别分析BSI及FACED积分的影响因素;分别根据支气管扩张严重程度(BSI)、FACED积分将入组患者分为轻、中、重组,用单因素方差分析NLR在不同组之间的差异 。结果 血清NLR(r=0.67)、PLR(r=0.45)、CRP(r=0.56) 和BSI积分呈正相关(P值均<0.01)。血清NLR(r=0.53)、PLR(r=0.43)、CRP(r=0.45)和FACED积分呈正相关(P值均<0.01)。多重线性回归分析显示:NLR(β系数1.29,95%CI 0.95～1.72,P=0.01)、CRP(β系数1.24,95%CI 0.68～1.55,P<0.01)对BSI积分的影响均有统计学意义,NLR(β系数1.25,95%CI 0.70～1.66,P=0.02)、CRP(β系数1.20,95%CI 0.53～1.60,P=0.01)对FACED积分的影响均有统计学意义。BSI及FACED积分越高NLR水平越高,NLR分别在两种积分不同严重程度组间差别均有统计学意义(P值均<0.05)。结论 NLR是预测支扩症急性加重期严重程度的有用指标。

Correlation between neutrophil/lymphocyte ratio and severity in acute exacerbation of bronchiectasis

Objective To investigate the correlation between the neutrophil/lymphocyte ratio (NLR) and the severity in acute exacerbation of bronchiectasis. Methods The data of 481 case of bronchiectasis who were hospitalized in the respiratory department of a hospital from January 2016 to April 2019 were retrospectively analyzed, and 191 patients with bronchiectasis who met the entry criteria were included into the research group, with 75 males and 116 females, and aged from 17 to 86 years with the average age of (59.23±13.34) years. The correlations between the laboratory parameters, such as NLR, hemoglobin (HB), platelet/lymphocyte ratio (PLR), and C-reaction protein (CRP), bronchiectasis severity index (BSI) and FACED score were assessed, and the multiple-linear regression analysis was performed to identify variables independently associated with BSI and FACED score. The included patients were divided into three groups according to BSI and FACED score, and the differences of NLR in different groups were analyzed by one-way ANOVA. Results The NLR (r=0.67), PLR (r=0.45), and CRP (r=0.56) were significantly positively correlated with BSI (all P<0.01). Meanwhile, NLR (r=0.53), PLR (r=0.43), and CRP (r=0.45) were also significantly positively correlated with the FACED score (all P<0.01). The multiple-linear regression analysis showed that NLR (β=1.29, 95%CI 0.95-1.72, P=0.01) and CRP (β=1.24, 95%CI 0.68-1.55, P<0.01) were independently associated with BSI. NLR (β=1.25, 95%CI 0.70-1.66, P=0.02) and CRP (β=1.20, 95%CI 0.53-1.60, P=0.01) had statistically significant effects on the FACED score. Moreover, the higher the BSI and FACED score, the higher the level of NLR. The difference of NLR was statistically significant between the two groups with different severities (all P<0.05). Conclusion NLR is a useful predictor of the severity in acute exacerbation of bronchiectasis.