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Abstract：
UNASSIGNED: Hierarchical management is advocated in China to effectively manage chronic obstructive pulmonary disease (COPD) patients and reduce the incidence and mortality of acute exacerbation of COPD (AE-COPD). However, primary and community hospitals often have limited access to advanced equipment and technology. Complete blood count (CBC), which is commonly used in these hospitals, offers the advantages of being cost-effective and easily accessible. This study aims to evaluate the significance of routine blood indicators in aiding of diagnosing AE-COPD.
UNASSIGNED: In this research, we enrolled a total of 112 patients diagnosed with AE-COPD, 92 patients with stable COPD, and a control group comprising 60 healthy individuals. Clinical characteristics, CBC parameters, and serum CRP levels were collected within two hours. To assess the associations between NLR/PLR/MLR and CRP by Spearman correlation test. The diagnostic accuracy of NLR, PLR and MLR in AE-COPD was assessed using Receiver Operating Characteristic Curve (ROC) and the area under the curve (AUC). Binary Logistic Regression analysis was conducted for the indicators of NLR, PLR and MLR.
UNASSIGNED: We found that patients with AE-COPD had significantly higher levels of NLR, PLR and MLR in contrast to patients with stable COPD. Additionally, the study revealed a noteworthy correlation between CRP and NLR (rs=0.5319, P<0.001), PLR (rs=0.4424, P<0.001), and MLR (rs=0.4628, P<0.001). By utilizing specific cut-off values, the amalgamation of NLR, PLR and MLR augmented diagnostic sensitivity. Binary logistic regression analysis demonstrated that heightened NLR and MLR act as risk factors for the progression of AE-COPD.
UNASSIGNED: The increasing levels of NLR, PLR and MLR could function as biomarkers, akin to CRP, for diagnosis and assessment of acute exacerbations among COPD patients. Further research is required to validate this concept.
UNASSIGNED: In this research, we enrolled a total of 112 patients diagnosed with AE-COPD, 92 patients with stable COPD, and a control group comprising 60 healthy individuals. Clinical characteristics, CBC parameters, and serum CRP levels were collected within two hours. To assess the associations between NLR/PLR/MLR and CRP by Spearman correlation test. The diagnostic accuracy of NLR, PLR and MLR in AE-COPD was assessed using Receiver Operating Characteristic Curve (ROC) and the area under the curve (AUC). Binary Logistic Regression analysis was conducted for the indicators of NLR, PLR and MLR.
UNASSIGNED: We found that patients with AE-COPD had significantly higher levels of NLR, PLR and MLR in contrast to patients with stable COPD. Additionally, the study revealed a noteworthy correlation between CRP and NLR (rs=0.5319, P<0.001), PLR (rs=0.4424, P<0.001), and MLR (rs=0.4628, P<0.001). By utilizing specific cut-off values, the amalgamation of NLR, PLR and MLR augmented diagnostic sensitivity. Binary logistic regression analysis demonstrated that heightened NLR and MLR act as risk factors for the progression of AE-COPD.
UNASSIGNED: The increasing levels of NLR, PLR and MLR could function as biomarkers, akin to CRP, for diagnosis and assessment of acute exacerbations among COPD patients. Further research is required to validate this concept.
摘要：
■中国提倡分级管理，以有效管理慢性阻塞性肺疾病（COPD）患者，降低COPD急性加重（AE-COPD）的发生率和死亡率。然而,基层医院和社区医院通常无法获得先进的设备和技术。全血细胞计数（CBC），通常在这些医院中使用，提供了具有成本效益和易于访问的优势。本研究旨在评估血常规指标在辅助诊断AE-COPD中的意义。
■在这项研究中，我们共纳入112例诊断为AE-COPD的患者，92例稳定期COPD患者，和一个由60名健康个体组成的对照组。临床特征,CBC参数,并在2小时内收集血清CRP水平。采用Spearman相关检验评价NLR/PLR/MLR与CRP的相关性。NLR的诊断准确性，使用受试者工作特征曲线（ROC）和曲线下面积（AUC）评估AE-COPD中的PLR和MLR。对NLR指标进行二元Logistic回归分析，PLR和MLR。
■我们发现AE-COPD患者的NLR水平明显较高，PLR和MLR与稳定期COPD患者形成对比。此外,研究显示CRP与NLR之间存在显著的相关性(rs=0.5319,P<0.001),PLR（rs=0.4424，P<0.001），和MLR(rs=0.4628,P<0.001)。通过利用特定的截止值，NLR的合并，PLR和MLR增强了诊断灵敏度。二元logistic回归分析显示NLR和MLR升高是AE-COPD进展的危险因素。
■随着NLR水平的提高，PLR和MLR可以作为生物标志物，类似于CRP，用于COPD患者急性加重的诊断和评估。需要进一步的研究来验证这一概念。
■在这项研究中，我们共纳入112例诊断为AE-COPD的患者，92例稳定期COPD患者，和一个由60名健康个体组成的对照组。临床特征,CBC参数,并在2小时内收集血清CRP水平。采用Spearman相关检验评价NLR/PLR/MLR与CRP的相关性。NLR的诊断准确性，使用受试者工作特征曲线（ROC）和曲线下面积（AUC）评估AE-COPD中的PLR和MLR。对NLR指标进行二元Logistic回归分析，PLR和MLR。
■我们发现AE-COPD患者的NLR水平明显较高，PLR和MLR与稳定期COPD患者形成对比。此外,研究显示CRP与NLR之间存在显著的相关性(rs=0.5319,P<0.001),PLR（rs=0.4424，P<0.001），和MLR(rs=0.4628,P<0.001)。通过利用特定的截止值，NLR的合并，PLR和MLR增强了诊断灵敏度。二元logistic回归分析显示NLR和MLR升高是AE-COPD进展的危险因素。
■随着NLR水平的提高，PLR和MLR可以作为生物标志物，类似于CRP，用于COPD患者急性加重的诊断和评估。需要进一步的研究来验证这一概念。
