常见COPD恶化的生物标志物 (NLR,PLR,SII):追溯研究中的诊断和临床管理影响
Yufen Fu1,2,3, Yuxin Wang1,4, Yujiao Wang1,4
1Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China.
概括
中性粒细胞与淋巴细胞的比率 (NLR) 和血小板与淋巴细胞的比率 (PLR) 能够有效地识别患有慢性阻塞性肺病 (COPD) 的患者,这些患者面临频繁恶化高风险. 一个新的评分系统有助于在资源有限的环境中管理.
科学领域:
- 肺部医学 肺部医学
- 炎症生物标志物 炎症生物标志物
- 临床诊断 临床诊断 临床诊断
背景情况:
- 慢性阻塞性肺病 (COPD) 的管理受到频繁恶化的挑战.
- 识别患有恶化的高风险的患者对于及时干预至关重要.
- 现有的生物标志物可能不具有成本效益或在所有环境中不易获得.
研究的目的:
- 评估中性粒细胞与淋巴细胞比率 (NLR),血小板与淋巴细胞比率 (PLR) 和系统性免疫炎症指数 (SII) 的诊断和预测价值,用于频繁的COPD恶化.
- 开发一个风险分层评分系统,以优化临床管理,特别是在资源有限的医疗机构.
主要方法:
- 对16849名COPD患者进行了回顾性观察性研究,分为频繁 (≥2次/年) 和不频繁的恶化.
- 临床特征和炎症生物标志物的分析,包括NLR,PLR,SII,CRP和PCT.
- 利用斯皮尔曼相关性,ROC曲线分析和二进制后勤回归来评估生物标志物性能并开发风险评分系统.
主要成果:
- 与非频繁恶化症相比,频繁恶化症的NLR,PLR和SII显著更高 (所有病例P<0.001).
- NLR,PLR和SII与CRP和PCT (P<0.001) 有正相关性.
- NLR和PLR被确定为最佳诊断指标和频繁恶化的独立风险因素,导致风险分层体系 (低风险,中等风险,高风险).
结论:
- 中性粒细胞与淋巴细胞的比率 (NLR) 和血小板与淋巴细胞的比率 (PLR) 是具有成本效益的生物标志物,用于识别高风险的COPD患者在初级保健中频繁恶化.
- 开发的基于百分点的评分系统为资源有限的医疗保健环境提供了定制的管理策略.
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