天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (6): 547-551.

• 临床研究 • 上一篇    下一篇

NLR和FIB与COPD合并T2DM的相关性 #br#

赵建美 1，张艳 1，李惠芳 1，何庆 2△，邵岩 1
  

  1. 1天津市滨海新区中医医院内科（邮编300451）；2天津医科大学总医院内分泌代谢科

  • 收稿日期:2019-06-05 修回日期:2019-10-23 出版日期:2020-06-15 发布日期:2020-06-15
  • 通讯作者: 何庆 E-mail:Hech69@hotmail.com
  • 基金资助:
    血必净治疗非重症社区获得性肺炎的疗效评价及对NLR的影响

Study on the levels of NLR and FIB and their correlation in patients with COPD and T2DM #br#

ZHAO Jian-mei1, ZHANG Yan1, LI Hui-fang1, HE Qing2△, SHAO Yan1 #br#   

  1. 1 Department of Medicine, Tianjin Binhai New Area Chinese Medicine Hospital, Tianjin 300451, China; 2 Department of
    Endocrinology, Tianjin Medical University General Hospital
  • Received:2019-06-05 Revised:2019-10-23 Published:2020-06-15 Online:2020-06-15
  • Contact: HE Qing E-mail:Hech69@hotmail.com

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摘要： 摘要：目的 探究慢性阻塞性肺疾病（COPD）合并2型糖尿病（T2DM）患者的中性粒细胞/淋巴细胞比值（NLR）和 纤维蛋白原（FIB）水平及其相关性。方法 选择稳定期COPD患者120例，根据疾病情况将患者划分成A、B、C组，A 组为COPD不合并T2DM者（40例），B组为COPD合并T2DM且无微血管病变者（40例），C组为COPD合并T2DM有微 血管病变者（40例）。患者于清晨空腹抽取静脉血，测量白细胞、中性粒细胞及淋巴细胞计数，计算NLR。采用酶联 免疫分析法检测FIB、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDLC）、超敏C-反应蛋白（hs-CRP）；并测定患者肺功能指标。结果 B、C组吸烟年限、1年内COPD急性加重住院次数、 高血压史比例均高于A组（均P＜0.05）。A、B、C组患者NLR、FIB水平依次升高，组间多重比较差异均有统计学意义 （均P＜0.05）。在稳定期COPD患者中，是否合并T2DM与吸烟年限、1年内COPD急性加重住院次数、高血压史、NLR 及FIB之间呈正相关（rs分别为0.125、0.151、0.231、0.342、0.312，均P＜0.05）。在稳定期COPD合并T2DM患者中，有 无微血管病变与吸烟年限、高血压史、NLR及FIB之间呈正相关（rs分别为0.143、0.198、0.421、0.350，均P＜0.05）。多 因素Logistic 回归分析结果显示，NLR（OR=1.644，95%CI：1.359~1.899）、FIB（OR=1.647，95%CI：1.386~1.931）升高是 稳定期 COPD 患者合并 T2DM 的危险因素；NLR（OR=1.731，95%CI：1.456~1.978）、FIB（OR=1.698，95%CI：1.543~ 1.928）升高是稳定期COPD合并T2DM患者发生微血管并发症的危险因素。结论 COPD合并T2DM及有微血管病 变与NLR、FIB相关，NLR、FIB可作为评估稳定期COPD合并T2DM病情严重程度及预后的生物学指标。

关键词: 肺疾病, 慢性阻塞性, 糖尿病, 2型, 糖尿病血管病变, 纤维蛋白原, 中性粒细胞/淋巴细胞比值

Abstract: Abstract: Objective To investigate the relationship between neutrophil/lymphocyte ratio (NLR) and fibrinogen (FIB) levels in patients with chronic obstructive pulmonary disease (COPD) and type II diabetes mellitus (T2DM). Methods The clinical information of 120 patients who went to our hospital from July 2017 to January 2019 and met the inclusion criteria was collected. According to the disease, patients were divided into three groups: group A (COPD patients without T2DM, n= 40), group B (patients with COPD and T2DM without microangiopathy, n=40) and group C (patients with COPD and T2DM and with microangiopathy, n=40). The venous blood samples were drawn from patients, and the leukocytes, neutrophil and lymphocyte counts were measured. The neutrophil/lymphocyte ratio (NLR) was calculated. The enzyme-linked immunosorbent assay was used to detect FIB, triacylglycerol (TG), total cholesterol (TC), low density lipoprotein cholesterin (LDL)-C, high density lipoprotein cholesterin (HDL)-C and high-sensitivity C-reactive protein (hs-CRP). The lung function indexes were also measured. Results The years of smoking, the times of acute exacerbation of COPD and the proportion of hypertension history were all higher in group B and group C than those in group A (P＜0.05). The levels of NLR and FIB increased in turn in group B and group C, and there were significant differences between the groups (P＜0.05). In stable COPD patients, T2DM was positively correlated with smoking years (r=0.125, P＜0.05), number of acute exacerbations of COPD in one year (rs=0.151, P＜0.05), history of hypertension (rs=0.231, P＜0.05), NLR (rs=0.342, P＜0.05) and FIB (rs= 0.312, P＜0.05). Patients with stable COPD and T2DM, microvascular complications were positively correlated with smoking years (rs=0.143, P＜0.05), prevalence of hypertension (rs=0.198, P＜0.05), NLR (rs=0.421, P＜0.05), and FIB (rs=0.350, P＜0.05). Multivariate Logistic regression analysis showed that the increased NLR (OR=1.644, 95%CI: 1.359-1.899) and FIB (OR=1.647, 95%CI: 1.386-1.931) were independent risk factors for stable COPD combined with T2DM (P＜0.05). The increased NLR (OR=1.731, 95%CI: 1.456-1.978) and FIB (OR=1.698, 95%CI: 1.543-1.928) were independent risk factors for microvascular disease in stable COPD combined with T2DM (P＜0.05). Conclusion COPD combined with T2DM and microvascular complications are closely related to NLR and FIB. NLR and FIB can be used as biomarkers for effectively assessing the severity and prognosis of stable COPD combined with T2DM.

Key words: pulmonary disease, chronic obstructive, diabetes mellitus, type 2, diabetic angiopathies, fibrinogen,
neutrophil/lymphocyte ratio