The Value of Neutrophil to Lymphocyte Ratio in the Prediction of Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Background: Chronic obstructive pulmonary disease (COPD) is associated with the pulmonary and systemic inflammatory response. Neutrophil to lymphocyte ratio (NLR) was considered as a prognostic inflammatory marker in many inflammatory diseases. We aimed to assess the value of Neutrophil to Lymphocyte ratio in the prediction of Chronic Obstructive Pulmonary Disease. Method: One hundred and twenty COPD patients (do not receive systemic corticosteroid in the last three months before conducting the study) divided into two groups: 60 stable COPD patients as a group I and 60 acute exacerbated COPD patients as a group II were included in this study. Other 60 apparently healthy subjects served as a control group. We evaluate NLR according to neutrophil count and lymphocyte count in complete blood count, C Reactive protein (CRP) Spirometry was done at least three times for all patients. Results: We found that the neutrophil count and NLR were significantly elevated in stable COPD (4.63+ 0.65, 3.19+ 0.97) respectively, than Healthy control (2.93+ 0.51, 1.55+ 0.73) respectively, and also, in AECOPD group (6.66+ 0.53, 5.36+ 1.46) than stable COPD group. However, there was no significant difference of total leukocytic count between the all studies groups. NLR was inversely correlated with forced expiratory volume in the 1 second (FEV1) (r= 0.390, p= 0.000) and FEV1/FVC (r= 0.234, p= 0.010) There was a significant positive correlation between NLR and CRP (r=0.469, p=0.0001) But there was no correlation with NLR and total CAT score (r= 0.0822, p= 0.5324) Conclusion: Our finding suggested that the neutrophil to lymphocyte ratio can be used as a good marker for prediction and detection of the acute exacerbation of COPD also for assessment and follow up the treatment.