Background

Both C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) are commonly elevated in patients with asthma. It is necessary to develop a novel marker, the combined score of CRP level and NLR (C-NLR score) based on cutoff points of CRP and NLR, and apply it in asthma diagnosis. The aim of this study was to explore whether C-NLR could distinguish children with exacerbated asthma.

Methods

Children suffering from exacerbated asthma were regarded as the asthmatic group (n = 86), which was divided into three groups: mild (n = 54), moderate (n = 17), and severe (n = 15). The control group consisted of children without any allergic disease and infection (n = 38). To compare CRP level and NLR between the asthmatic group and control group, a receiver-operating characteristic curve was constructed to determine area under the curve (AUC) and optimal cutoff point. Thereafter, the C-NLR score was classified as follows: C-NLR score of 2 with an elevated CRP level and high NLR, a C-NLR score of 1 with one of these abnormalities, and a C-NLR score of 0 with a normal CRP level and low NLR. The C-NLR score was then compared among different asthma groups.

Results

In the control group, the CRP level and NLR were 1.9 (0.5–2.6) mg/L and 1.01 (0.69–1.31), respectively. In the asthmatic group, the CRP level and NLR were 7.3 (3.2–14.2) mg/L and 3.08 (1.73–5.34), respectively, which were higher than those in the control group (p < 0.001 for CRP and p < 0.001 for NLR). The AUC of CRP was 0.86, and the optimal cutoff point was 3.6 mg/L. The AUC of NLR was 0.86, and the optimal cutoff point was 1.72. The AUC of the C-NLR score was 0.94, and the optimal cutoff point was 1.

Conclusions

C-NLR, a novel inflammatory marker, was applied here for the exacerbated asthma for the first time. Our study has shown C-NLR is a promising marker to distinguish children with exacerbated asthma from healthy children.

中文翻译：

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C反应蛋白水平和中性粒细胞与淋巴细胞比率的综合评分：区分哮喘加重儿童的新标志物

背景

哮喘患者的 C 反应蛋白 (CRP) 水平和中性粒细胞与淋巴细胞的比率 (NLR) 通常都升高。有必要开发一种基于CRP和NLR分界点的CRP水平和NLR联合评分(C-NLR score)，并将其应用于哮喘诊断。本研究的目的是探讨 C-NLR 是否可以区分哮喘加重的儿童。

方法

哮喘加重的儿童被视为哮喘组（n = 86），分为三组：轻度（n = 54）、中度（n = 17）和重度（n = 15）。对照组由没有任何过敏性疾病和感染的儿童组成（n= 38)。为了比较哮喘组和对照组之间的CRP水平和NLR，构建了受试者工作特征曲线以确定曲线下面积（AUC）和最佳截止点。此后，C-NLR 评分如下分类：C-NLR 评分 2 分，CRP 水平升高和 NLR 高，C-NLR 评分 1 分，其中一种异常，C-NLR 评分 0 分，正常 CRP 水平和低 NLR。然后比较不同哮喘组的C-NLR评分。

结果

在对照组中，CRP 水平和 NLR 分别为 1.9（0.5-2.6）mg/L 和 1.01（0.69-1.31）。哮喘组CRP和NLR分别为7.3（3.2~14.2）mg/L和3.08（1.73~5.34），均高于对照组（CRP p < 0.001，p < 0.001） NLR)。CRP的AUC为0.86，最佳截止点为3.6 mg/L。NLR 的 AUC 为 0.86，最佳截止点为 1.72。C-NLR 评分的 AUC 为 0.94，最佳截止点为 1。

结论

C-NLR 是一种新型炎症标志物，首次应用于哮喘急性发作。我们的研究表明，C-NLR 是区分哮喘加重儿童和健康儿童的有希望的标志物。