Abstract
Background: Our hypothesis is that NLR could be a useful important inflammatory marker that detects the inflammatory status during acute exacerbations of COPD (AECOPD) and could identify early acute exacerbations for early management.
Methods: The cross-sectional study includes patients with Chronic Obstructive Pulmonary Disease irrespective of the severity and duration of disease. Study cases are personally interviewed to get relevant details after getting informed signed consent. Based upon inclusion and exclusion criteria a minimum of 100 cases are selected. An exacerbation of COPD is defined as an onset or worsening of more than two respiratory symptoms (ie, dyspnea, cough or wheeze, sputum amount or purulence) for two or more consecutive days.
Results: 46.00% patients duration of disease was more than 10 year and NLR was 4.45±1.28. The severity wise difference in NLR was statistically significant.
Conclusion: NLR can be used as a new inflammatory marker for assessment of inflammation in COPD patients. It is a good predictor for exacerbation of COPD. It is a quick, cheap, easily measurable with no need for a special request.
Keywords: NLR, COPD, Stable.
References
- Global Initiative for Chronic Obstructive Lung Disease (GOLD): Global Strategy for the Diagnosis, Management and prevention of Chronic Obstructive Pulmonary Disease. (2017 REPORT). Available from: http://www.goldcopd.org
- Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS medicine. 2006; 3(11):e442.
- Yin P, Wang H, Vos T, Li Y, Liu S, Liu Y, et al. A Subnational Analysis of Mortality and Prevalence of COPD in China From 1990 to 2013: Findings From the Global Burden of Disease Study 2013. Chest. 2016; 150(6):1269–80.
- Perera PN, Armstrong EP, Sherrill DL, Skrepnek GH. Acute exacerbations of COPD in the United States: inpatient burden and predictors of costs and mortality. Copd. 2012; 9(2):131–41.
- Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. The European respiratory journal. 2004; 23(6):932–46.
- Zahorec R. Ratio of neutrophil to lymphocyte counts—rapid and simple parameter of systemic inflammation and stress in critically ill. Bratislavskelekarskelisty. 2001; 102(1):5–14.
- Liu CL, Lee JJ, Liu TP, Chang YC, Hsu YC, Cheng SP. Blood neutrophil-to-lymphocyte ratio correlates with tumor size in patients with differentiated thyroid cancer. Journal of surgical oncology. 2013; 107 (5):493–7
- Templeton AJ, McNamara MG, Seruga B, Vera-Badillo FE, Aneja P, Ocana A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Journal of the National Cancer Institute. 2014; 106(6):dju124.
- Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert review of cardiovascular therapy. 2013; 11(1):55–9.
- de Jager CP, van Wijk PT, Mathoera RB, de Jongh-Leuvenink J, van der Poll T, Wever PC. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Critical care (London, England). 2010; 14(5):R192. Epub 2010/11/ 03. https://doi.org/10.1186/cc9309 PMID: 21034463.
- Zhou X, Li Q, Zhou X. Exacerbation of chronic obstructive pulmonary disease. Cell BiochemBiophys. 2015;73(2):349–355.
- Groenewegen KH, Postma DS, Hop WC, Wielders PL, Schlösser NJ, Wouters EF; COSMIC Study Group. Increased systemic in am- mation is a risk factor for COPD exacerbations. Chest. 2008;133(2): 350–357.
- Faria SS, Fernandes PC Jr, Silva MJ, et al. The neutrophil-tolymphocyte ratio: a narrative review. Ecancermedicalscience. 2016; 10:702.
- Yang T, Wan C, Wang H, et al. The prognostic and risk-strati ed value of neutrophil–lymphocyte count ratio in Chinese patients with community-acquired pneumonia. Eur J In amm. 2017;15(1):22–27. 50
- de Jager CP, Wever PC, Gemen EF, et al. The neutrophillymphocyte count ratio in patients with community-acquired pneumonia. PLoS One. 2012;7 (10):e46561.
Corresponding Author
Dr Yadvendra Gupta
Senior Resident, Department of Medicine, SMS Medical College and Hospital, Jaipur
DOI: https://dx.doi.org/10.18535/jmscr/v8i6.55
