Values of peripheral blood RDW,NLR,FAR and SP-A in evaluating patient condition and risks of acute exacerbation of COPD
10.3969/j.issn.1006-5725.2024.22.021
- VernacularTitle:外周血RDW、NLR、FAR、SP-A检测对慢性阻塞性肺疾病患者病情及急性加重风险的评估价值
- Author:
Lijun LIU
1
;
Xiangyun LI
;
Yajuan YANG
Author Information
1. 河北大学附属医院呼吸与危重症医学科(河北 保定 071000)
- Keywords:
RDW;
NLR;
FAR;
SP-A;
COPD;
condition;
acute exacerbation
- From:
The Journal of Practical Medicine
2024;40(22):3244-3250
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the values of peripheral blood red blood cell distribution width(RDW),neutrophil(NEU)to lymphocyte(LYM)ratio(NLR),fibrinogen(FIB)to albumin(ALB)ratio(FAR)and surfactant protein A(SP-A)in evaluating patient condition and risks of acute exacerbation of COPD.Methods A total of 200 patients with COPD admitted to Hebei University Affiliated Hospital from January 2021 to December 2023 were selected as study subjects.All the patients had follow-up visits in the outpatient department within the past three months.According to the presence or absence of acute exacerbation,they were divided into exacerbation group(n=96)and non-exacerbation group(n=104).Meanwhile,50 healthy volunteers were assigned to a control group.Peripheral blood RDW,NEU,LY,FIB,ALB and SP-A in the three groups were compared.NLR and FAR were cal-culated.The correlation of RDW,NLR,FAR,and SP-A with the severity of AECOPD was analyzed.ROC curves were used to analyze the values of RDW,NLR,FAR,and SP-A in evaluating the risks of acute exacerbation of COPD.Multivariate logistic regression analysis was conducted to identify the risk factors for AECOPD.The differences in RDW,NLR,FAR,and SP-A were compared among the patients with different prognoses.Results Peripheral blood RDW,NEU,NLR,FIB,FAR and SP-A were higher in the exacerbation group than in the non-exacerbation group,whereas LYM and ALB were lower(P<0.05).Levels of RDW,NLR,FAR and SP-A were higher in the patients with grade Ⅲ AECOPD than those with grade Ⅱ or grade Ⅰ AECOPD(P<0.05).RDW,NLR,FAR,SP-A,and grade of patient condition in patients with AECOPD were positively correlated in pairs(P<0.05).The sensitivity,specificity and area under the ROC curve of combined prediction of AECOPD using RDW,NLR,FAR and SP-A were 0.798 and 0.830(95%CI:0.738～0.922),all of which were superior to prediction using a single indicator.Multivariate analysis found that smoking,RDW>14.33%,NLR>2.80,FAR>0.08,and SP-A>2.21 ng/mL were risk factors for acute exacerbation of COPD(P<0.05).RDW,NLR,FAR,and SP-A in the readmission group within 30 days after discharge were higher than those in the non-readmission group(P<0.05).Conclusions RDW,NLR,FAR,and SP-A are closely related to the patient condition of COPD,and can help to predict the risk of acute exacerbation and prognosis.Therefore,they are worthy of monitoring in clinical practice.
