中性粒细胞/淋巴细胞比率及血小板平均体积在慢性阻塞性肺病急性加重期细菌感染的诊断价值

doi:10.3969/j.issn.1006-6233.2022.10.027

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Abstract Objective: To explore the diagnostic value of neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) on bacterial infection during acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods: Clinical data of 101 elderly patients with acute exacerbation of COPD admitted between February 2019 and February 2022 were retrospectively analyzed.According to sputum bacteriological culture results,the patients were divided into infected group (n=62) and non-infected group (n=39).The white blood cell (WBC) count,platelet (PLT) count,NLR and MPV were compared between the two groups at admission. Receiver operating characteristic curve (ROC curve) was plotted to explore the diagnostic value of the aforementioned indicators on bacterial infection during acute exacerbation of COPD.After 1 week of treatment,patients were observed for changes in WBC,PLT,NLR and MPV. Results: WBC,NLR and MPV of (10.48±3.53) ×10⁹ cell/L,(9.89±3.14) and (12.48±3.74) fl in infected group were significantly higher than (7.90±2.11) ×10⁹ cell/L,(6.05±1.70) and (7.82±2.50) fl in non-infected group (t=4.131,6.998,6.866,P<0.001).However,there was no statistical significance in PLT level between the two groups [(256.50±96.06) ×10⁹ cell/L vs (272.62±49.75) ×10⁹ cell/L] (t=-0.968,P>0.05).The areas under ROC curves of WBC,NLR and MPV were 0.743,0.855 and 0.849 in the diagnosis of bacterial infection during acute exacerbation of COPD (P<0.001),and the critical values were 10.5×10⁹ cell/L,8.5 and 9.5 fl respectively.The specificity of NLR combined with MPV in series was the highest,with the misdiagnosis rate of 2.6% (1/39).The sensitivity of NLR combined with MPV in parallel was the highest,with the missed diagnosis rate of 9.7% (6/62).After 1 week of treatment,WBC,NLR and MPV of (7.15±2.04) ×10⁹ cell/L,(5.18±1.16) and (7.54±1.38) fl in patients with acute exacerbation of COPD were reduced compared with (9.49±3.30) ×10⁹ cell/L,(8.41±3.26) and (10.68±4.02) fl before treatment (t=8.808,14.688,11.688,P<0.001),However,there was no statistical difference before and after PLT treatment [(262.72±81.43) ×10⁹ cell /L vs (273.74±48.65) ×10⁹ cell/L] (t=-1.703,P>0.05). Conclusion: NLR and MPV can be used as sensitive indicators to predict bacterial infection during COPD acute exacerbation,and have certain application value in the early diagnosis and treatment of patients.

Key words： Chronic obstructive pulmonary disease Acute exacerbation Bacterial infection Neutrophil/lymphocyte ratio Mean platelet volume

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	CHEN Jiacui
	PENG Song
	YU Zhiyan

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CHEN Jiacui,PENG Song,YU Zhiyan. Diagnostic Value of Neutrophil/Lymphocyte Ratio and Mean Platelet Volume on Bacterial Infections During Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J]. HeBei Med, 2022, 28(10): 1726-1730.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.10.027 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I10/1726

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