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Diagnostic Value of Neutrophil/Lymphocyte Ratio and Mean Platelet Volume on Bacterial Infections During Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
CHEN Jiacui, PENG Song, YU Zhiyan |
Hefei First People's Hospital, Anhui Hefei 230031, China |
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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.
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