Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as potential biomarkers of acute exacerbation in children with non-cystic fibrosis bronchiectasis

Abstract

Purpose: Non- cyctic fibrosis bronchiectasis (non-CFBE) is a chronic inflammatory lung disease which causes significant morbidity in children. Exacerbations in non-CFBE are associated with worsening lung function. Several laboratory parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) have been suggested to be as an indicator in various chronic inflammatory diseases. We aimed to asses the value of the NLR, PLR and MPV as markers of acute exacerbation in pediatric patients with non-CFBE. Methods: The NLR, PLR, and MPV values of 55 non-CFBE patients (during exacerbation and stable state periods) and 79 healthy control subjects were analyzed. Results: The mean ages for the patient and control group were 13.62±3.5 and 12.72±2.68 years, respectively. 64% of patients and 54% of control subjects were male. The white blood cell count, absolute neutrophil count, and NLR values were significantly higher in the exacerbation group than in the healthy control group (p<0.05). MPV and PLR values were not significantly different between the two groups. Only forced expiratory volume in one second (FEV1) and C-reactive protein level were significantly different (p<0.001) between the acute exacerbation and stable state periods in the Purpose: Non- cyctic fibrosis bronchiectasis (non-CFBE) is a chronic inflammatory lung disease which causes significant morbidity in children. Exacerbations in non-CFBE are associated with worsening lung function. Several laboratory parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) have been suggested to be as an indicator in various chronic inflammatory diseases. We aimed to asses the value of the NLR, PLR and MPV as markers of acute exacerbation in pediatric patients with non-CFBE.

Methods: The NLR, PLR, and MPV values of 55 non-CFBE patients (during exacerbation and stable state periods) and 79 healthy control subjects were analyzed.

Results: The mean ages for the patient and control group were 13.62±3.5 and 12.72±2.68 years, respectively. 64% of patients and 54% of control subjects were male. The white blood cell count, absolute neutrophil count, and NLR values were significantly higher in the exacerbation group than in the healthy control group (p<0.05). MPV and PLR values were not significantly different between the two groups. Only forced expiratory volume in one second (FEV1) and C-reactive protein level were significantly different (p<0.001) between the acute exacerbation and stable state periods in the patient group. Conclusion: Despite the NLR value being significantly higher in children with non-CFBE than in healthy control subjects, it did not differentiate between the steady-state and acute exacerbations periods of the disease. PLR and MPV values also cannot be used as markers of acute exacerbation in children with non-CFBE.

Keywords

• Bronchiectasis
• non-cystic fibrosis bronchiectasis
• neutrophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio
• mean platelet volume

Nötrofil- lenfosit oranı ve trombosit- lenfosit oranlarının çocuklardaki kistik fibroz dışı bronşektazinin akut alevlenmesinde potansiyel biyolojik gösterge olarak değerlendirmesi

Öz

Özet

Amaç: Kistik fibroz dışı bronsektazi (KFDBE) çocuklarda önemli morbiditeye yol açan kronik inflamatuar akciğer hastalığıdır. KFDBE'de alevlenme akciğer fonksiyonlarının kötüye gitmesi ile ilişkilidir. Nötrofil- lenfosit oranı (NLO), trombosit- lenfosit oranı (TLO) ve ortalama trombosit hacmi (OTH) gibi bazı laboratuar parametrelerinin çesitli kronik inflamatuar hastalıkları için bir gösterge olduğu öne sürülmüştür. Çalışmamızda, KFDBE’li çocuklardaki akut alevlenmede NLO, TLO ve OTH ölçümlerinin bir gösterge olarak değerlendirilmesini amaçladık.

Gereç ve yöntem: Çalışmada, akut alevlenme ve stabil dönemdeki 55 KFDBE' li hastanın ve 79 sağlıklı kontrol grubunun NLO, TLO ve OTH değerleri analiz edildi.

Bulgular: Çalışma ve kontrol grubundaki hastaların ortalama yaşları sırasıyla 13,62±3,5 ve 12,72±2,68 yıldı. Çalışma grubunun %64'ü ve kontrol grubunun %54'ü erkekti. Alevlenme dönemindeki grupta beyaz küre sayısı, nötrofil oranı ve NLO değerleri sağlıklı kontrol grubundan anlamlı olarak yüksekti (p<0,05). İki gruptaki TLO ve OTH değerleri arasında anlamli fark yoktu. Çalışma grubunun akut alevlenme ve stabil dönemleri arasında, sadece ilk bir saniyede zorlu ekspiryum hacmi (FEV1) ve c-reaktif protein (CRP) seviyeleri arasında anlamlı fark vardı (p<0,001).

Sonuç: Her ne kadar KFDBE' li çocuklardaki NLO değeri sağlıklı kontrol grubundaki çocuklara göre anlamlı ölçüde yüksek olsa da hastalığın stabil durum ve akut alevlenme periyodu arasında NLO değeri farklılık göstermedi. TLO ve OTH değerleri, KFDBE'li çocuklardaki akut alevlenmelerde bir gösterge olarak kullanılamaz.

Anahtar Kelimeler

• Bronşektazi
• kistik fibroz dışı bronşektazi
• nötrofil-lenfosit oranı
• trombosit-lenfosit oranı
• ortalama trombosit hacmi

Kaynakça

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