背景与目的慢性阻塞性肺疾病(COPD)是一种以炎症为特征的呼气气流受限的疾病。最近,炎症相关的生物标志物,如中性粒细胞-淋巴细胞比率(NLR),血小板-淋巴细胞比率(PLR),和单核细胞-淋巴细胞比值(MLR)已被用于预测COPD的预后。这项研究的目的是评估生物标志物的作用,如NLR,PLR,和MLR在重症监护的COPD患者,并检查这些标志物预测预后的能力[住院时间(LOSH),机械通气(MV)的持续时间,ICU住院时间(LOSICU),和死亡率]。方法回顾性分析2018-2019年ICU收治的562例患者。其中,369例COPD患者。我们评估了包括患者人口统计学在内的临床数据,Charlson合并症指数(CCI),急性生理学和慢性健康评估II(APACHEII)评分,序贯器官衰竭评估(SOFA)评分,LOSICU,LOSH,MV的持续时间,以及NLR,PLR,和MLR值。从死亡通知系统获得患者死亡数据(30天死亡率)。结果年龄,LOSH,CCI和SOFA可预测COPD患者的死亡率。在有死亡率的情况下,年龄,使用正性肌力,MV持续时间,LOSICU,APACHEII,CCI,SOFA,淋巴细胞计数,中性粒细胞计数,血小板计数,单核细胞计数,NLR,PLR,和MLR水平在统计学上显着高于无死亡病例。NLR呈正相关且统计学意义较低,PLR,和MLR有预后因素,如MV持续时间,APACHEII得分,和SOFA分数。结论NLR,PLR,MLR值可作为重症监护COPD患者的预后指标。虽然有许多研究支持使用生物标志物,如NLR,PLR,和MLR作为预后指标,仍需要对该主题进行进一步的比较研究,以获得对该主题的更深入见解。
Background and objective Chronic obstructive pulmonary disease (COPD) is a condition in which the expiratory airflow is restricted and is characterized by inflammation. Recently, inflammation-related biomarkers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) have been used to predict the prognosis in COPD. The aim of this study was to evaluate the role of biomarkers such as NLR, PLR, and MLR in COPD patients in intensive care and to examine the ability of these markers to predict the prognosis [length of stay in hospital (LOSH), duration of mechanical ventilation (MV), length of stay in ICU (LOS ICU), and mortality]. Methods A total of 562 patients who were treated in the ICU between 2018 and 2019 were retrospectively reviewed. Among them, 369 were patients with COPD. We evaluated clinical data including patient demographics, Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, LOS ICU, LOSH, duration of MV, as well as NLR, PLR, and MLR values. Data on patient deaths (30-day mortality) was obtained from the Death Notification System. Results Age, LOSH, CCI, and SOFA were found to predict mortality in COPD patients. In cases with mortality, age, inotropic use, MV duration, LOS ICU, APACHE II, CCI, SOFA, lymphocyte count, neutrophil count, platelet count, monocyte count, NLR, PLR, and MLR levels were statistically significantly higher than those in cases without mortality. There was a positive and low statistically significant relationship of NLR, PLR, and MLR with prognostic factors like MV duration, APACHE II scores, and SOFA scores. Conclusion The NLR, PLR, and MLR values may be used as prognostic indicators in COPD patients in intensive care. Although there are many studies endorsing the use of biomarkers such as NLR, PLR, and MLR as prognostic indicators, further comparative studies on this subject are still required to gain deeper insights into the topic.