中性粒细胞／淋巴细胞比值对老年慢性肾脏病患者发生缺血性脑卒中的预测价值  

Neutrophil/lymphocyte ratio in prediction of incidence of ischemic stroke in elderly persons with chronic kidney disease

作　　者：付晨[1] 姚兰[2] 陈妹君 杨洁[1] 陈海平[2] 

机构地区：[1]北京积水潭医院肾内科,100035 [2]首都医科大学附属北京友谊医院医疗保健中心内科老年肾病组,北京100050

出　　处：《中国医师杂志》2017年第11期1680-1683,1687,共5页Journal of Chinese Physician

摘　　要：目的评估老年慢性肾脏病患者中性粒细胞／淋巴细胞比值（NLR）对于缺血性脑卒中的预测价值。方法采用回顾队列研究设计，研究对象为2004年至2015年曾就诊北京友谊医院医保中心、基线年龄≥60岁、有至少连续36个月完整临床资料的慢性肾脏病（CKD）患者220例。计算NLR中位数，将CKD患者分为NLR92．13组与NLR〈2．13组，在随访的11年中以缺血性脑卒中作为终点事件，并进行相关分析，评价NLR对老年CKD患者发生缺血性脑卒中的预测价值。结果随访中共发生161个缺血性卒中事件。NLR≥2．13组与〈2．13组生存曲线差异有统计学意义（10g—rankChi—square=4．963，P=0．026）。NLR为老年CKD患者发生卒中的独立危险因素，卒中发生的相对危险比为1．11（95％CI：1．007—1．223，P=0．035）。结论在老年慢性肾脏病患者中，NLR是缺血性脑卒中的独立危险因素及预测因子。Objective To investigate the relationship of the neutrophil to lymphocyte ratio （NLR） with stroke in elderly persons with CDK. Methods Totally 220 subjects with stage 3 -5 CKD were followed. Fatal and nonfatal eerebrovascular event （CVE） were recorded during this period. NLR at baseline was determined from complete blood count differential. We investigated if NLR could predict stroke. Re- suits Median NLR was 2. 13. NLR was equally associated with estimated glomerular flitrationrate （eGFR）. Totally 116 strokes occurred during follow-up period. NLR could predict stroke independently. Increased NLR over 2. 13 was related to a significantly decreased survival time （log-rank Chi-square = 4. 963, P = 0. 026）. Multivariate Cox regression analysis showed that the risk factor of ischemic stroke in CKD patients was high NLR, hazard ratio （HR） 1.11 [95% confidence interval （CI） 1. 007 to 1. 223, P = 0. 0351. Conclusions NLR could independently predict stroke in elderly patients with moderate to severe CKD.

关 键 词：中性白细胞/代谢 淋巴细胞/代谢 肾疾病/并发症/代谢 卒中/并发症/代谢 

分 类 号：R692[医药卫生—泌尿科学] R743.3[医药卫生—外科学]