摘要
目的 探究D-二聚体、中性粒细胞与淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、C反应蛋白(CRP)、第一秒用力呼气容积(FEV1)/用力肺活量(FVC)与慢性阻塞性肺疾病(COPD)严重程度的相关性.方法 选取2019 年8 月至2021 年10 月收治的113 例COPD住院患者作为COPD组,再根据第1 秒用力呼气容积占预计值百分比分为中轻度组76 例、重度组37 例;另选取同期行健康体检的健康人50 例作为健康对照组.对所有纳入研究者检查血清D-二聚体、NLR、PLR、CRP水平,对比COPD组及健康对照组外周血各指标水平;对比不同病情程度COPD患者外周血各指标水平和肺功能FEV1/FVC水平;采用Pearson相关系数分析D-二聚体、NLR、PLR、CRP、FEV1/FVC水平与COPD患者病情程度的相关性;采用多因素Logistic回归分析COPD患者病情加重的危险因素.结果 COPD组D-二聚体、PLR、CRP、NLR水平较健康对照组显著升高(P＜0.05).重度组D-二聚体、PLR、CRP、NLR水平较中轻度组显著升高,FEV1/FVC水平较中轻度组显著降低(P＜0.05).D-二聚体、PLR、CRP、NLR均与COPD患者病情程度呈正相关(r=0.561、0.782、0.773、0.857,P＜0.01),FEV1/FVC水平与COPD患者病情程度呈负相关(r=-0.983,P＜0.01).D-二聚体与PLR呈正相关(r=0.872,P＜0.05);D-二聚体与CRP呈正相关(r=0.714,P＜0.05);PLR与CRP呈正相关(r=0.798,P＜0.05);NLR与CRP呈正相关(r=0.857,P＜0.05).D-二聚体、PLR、CRP、NLR水平偏高和FEV1/FVC水平偏低是 COPD患者病情加重的独立危险因素(P＜0.01).结论 D-二聚体、PLR、CRP、NLR、FEV1/FVC水平与COPD病情程度密切相关,可作为反映疾病病情变化的常规预测指标.
Abstract
Objective To investigate the correlation between D-dimer(DD),neutrophil to lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),C reactive protein(CRP),forced expiratory volume in the first second(FEV1)/forced vital capacity(FVC)and the severity of chronic obstructive pulmonary disease(COPD).Methods A total of 113 pa-tients with COPD admitted from August 2019 to October 2021 were selected as COPD group,and then according to the per-centage of forced expiratory volume in the first second in the expected value divided into moderate and mild group and severe group.Another 50 healthy people who underwent physical examination during the same period were selected as the healthy control group.The serum DD,NLR,PLR and CRP levels of all the included researchers were examined,and the levels of pe-ripheral blood indexes in COPD group and healthy control group were observed and compared.The levels of peripheral blood indexes and pulmonary function FEV1/FVC in COPD patients with different disease severity were compared.Pearson correla-tion coefficient was used to analyze the correlation between DD,NLR,PLR,CRP,FEV1/FVC levels and the severity of COPD patients.Multivariate Logistic regression was used to analyze the risk factors of exacerbation of COPD.Results The levels of DD PLR,CRP and NLR in COPD group were significantly higher than those in healthy control group(P＜0.05).The levels of DD,PLR,CRP and NLR in severe group were significantly higher than those in moderate and mild group,and the levels of FEV1/FVC were significantly lower than those in moderate and mild group(P＜0.05).DD,PLR,CRP and NLR were positively correlated with the severity of COPD patients(r=0.561,0.782,0.773,0.857,P＜0.01),while FEV1/FVC levels were negatively correlated with the severity of COPD patients(r=-0.983,P＜0.01).DD was positively correlated with PLR(r=0.872,P＜0.05),and with CRP(r=0.714,P＜0.05).PLR was positively correlated with CRP(r=0.798,P＜0.05),and NLR was positively correlated with CRP(r=0.857,P＜0.05).The higher levels of DD,PLR,CRP,NLR and the lower levels of inFEV1/FVC levels were independent risk factors for the exacerbation of COPD pa-tients(P＜0.01).Conclusion The levels of DD,PLR,CRP,NLR,and FEV1/FVC are closely related to the severity of COPD,which can be used as a routine predictor to reflect the change of disease condition.
基金项目
2022年佛山市自筹经费类科技计划项目(2320001009556)
国家科技期刊平台
NSTL
万方数据