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Objective To explore the predictive value of fibrinogen (FIB)/albumin (ALB) ratio (FAR), neutrophil (NEU)/lymphocyte (LYM) ratio (NLR) and platelet (PLT)/lymphocyte (LYM) ratio (PLR) to acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Acute exacerbation COPD (AECOPD) patients hospitalized in the Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Chengde Medical College from September 2019 to July 2021 were selected as AECOPD group (n=96), and patients with stable chronic obstructive pulmonary disease (SCOPD) and without acute exacerbation in the outpatient clinic for nearly three months in the same period were selected as SCOPD group (n=103), and healthy people who had physical examination in the same period were randomly selected as control group (n=80). According to the severity classification, AECOPD patients were divided into grade Ⅰ (n=20), grade Ⅱ (n=33) and grade Ⅲ (n=43). The general data and clinical data of each group were recorded, and the serum C-reactive protein (CRP), procalcitonin (PCT), white blood cells (WBC),NEU, LYM, PLT, FIB, ALB were detected. In AECOPD patients, carbon dioxide partial pressure (PaCO2) and arterial oxygen partial pressure (PaO2) were also detected, the FAR, NLR, PLR and oxygenation index (PaO2/FiO2) were calculated. The differences of the above indicators in each group were compared, and their correlation was analyzed. The risk factors of AECOPD were analyzed by multivariate logistic regression, and the receiver operating characteristics (ROC) curves were developed to analyze the significance of each indicator in the prediction of AECOPD. Results The levels of CRP, PCT, WBC, NEU, NLR, PLR and FAR decreased gradually (P<0.05) in control group, SCOPD group and AECOPD group; with the increase of AECOPD severity, the improvement time of patients, the levels of CRP, PCT, WBC, NEU as ell as NLR, PLR, FAR and PaCO2 increased gradually, and PaO2/FiO2 decreased gradually (P<0.05). Pearson or Spearman correlation analysis showed that FAR, NLR and PLR were positively correlated with the severity of AECOPD, improvement time, CRP, PCT, WBC and PaCO2, but negatively correlated with PaO2/FiO2 (P<0.01).Multivariate logistic regression analyses showed that FAR, NLR and PLR were the independent risk factors for AECOPD (P<0.05).ROC curve analysis showed that the AUC value was greater than 0.7 for predicting AECOPD with FAR, NLR and PLR alone or in combined usage, and the sensitivity was 0.990, 0.698, 0.563 and 0.958 respectively, and the specificity was 0.641, 0.883, 0.932 and 0.961. Conclusion FAR, NLR, PLR have certain correlation with the inflammatory level, severity and respiratory function of AECOPD, and joint use of the three indicators for detection may have higher predictive value for its occurrence.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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