慢性阻塞性肺疾病频繁加重的多因素分析

目的探讨多个血液学指标与慢性阻塞性肺疾病(简称慢阻肺)频繁加重的关系。方法采用回顾性研究,选取102例慢阻肺患者,根据1年内急性加重的次数分为频繁加重组(≥2次/年)55例,非频繁加重组(<2次/年)47例。通过独立样本t检验、χ~2检验、多因素Logistic回归分析法,探索血常规、血气分析中多个指标与慢阻肺频繁加重之间的关系。结果频繁加重组中性粒细胞计数(neutrophil count, NEUT)、中性粒细胞百分比(neutrophil percentage, NEU%)和中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio, NLR)高于非频繁加重组,而频繁加重组淋巴细胞计数(lymphocyte count, LY)、淋巴细胞百分比(lymphocyte percentage, LY%)低于非频繁加重组,差异均有统计学意义(均有P<0.05);NLR的OR(95%CI)值为3.483(1.170～10.373),动脉血二氧化碳分压(partial pressure of carbon dioxide in artery, PaCO_2)的OR(95%CI)值为1.124(1.053～1.201),NLR和PaCO_2是慢阻肺频繁加重的危险因素,随着NLR和PaCO_2的升高,慢阻肺频繁加重的风险升高,差异均有统计学意义(均有P<0.05)。结论慢阻肺频繁加重型患者的NLR和PaCO_2水平高于非频繁加重型,NLR和PaCO_2可能作为慢阻肺频繁加重的危险因素。

Analysis of the indicators of frequent exacerbation of chronic obstructive pulmonary disease

  Objective  To investigate the relationship between multiple blood indexes and frequent exacerbation of chronic obstructive pulmonary disease (COPD).  Methods  102 patients with COPD were selected and divided into frequent exacerbation group (≥ 2 times/year, 55 patients) and infrequent exacerbation group (< 2 times/year, 47patients), according to the frequency of acute exacerbation in one year. The relationship between multiple indicators in blood routine and blood gas analysis and frequent exacerbation of COPD was explored by independent sample t test, χ2 test, and multiple Logistic regression analysis. A retrospective study was conducted.  Results  Neutrophils count (NEU), neutrophils ratio (Neut%), and neutrophil-to-lymphocyte ratio (NLR) of frequent exacerbation group were significantly higher than those of infrequent exacerbation group, while lymphocytes (LY), lymphocytes ratio (LY%) were lower (All P<0.05). OR(95% CI) of NLR was 3.483(1.170-10.373), and OR(95% CI) of partial pressure of carbon dioxide in artery (PaCO₂) was 1.124(1.053-1.201).NLR and PaCO₂ were risk factors for frequent exacerbation of COPD. Increase of NLR and PaCO₂ led to an increasing risk of frequent exacerbation of COPD (All P<0.05).  Conclusions  The levels of NLR and PaCO₂ in COPD patients with frequent exacerbation are higher than those in patients with infrequent exacerbation. As a consequent, NLR and PaCO₂ could be considered risk factors for frequent exacerbation of COPD.