中性粒细胞与淋巴细胞比值在腹膜透析相关性感染中的临床意义  

The clinical significance of neutrophil-to-lymphocyte ratio in peritoneal dialysis related infection

作　　者：詹秋楠 陈晓莉[1] 李丹丹[1] 王瑞峰[1] 郝丽[1] 刘桂凌[1] ZHAN Qiu-Nan;CHEN Xiao-Li;LI Dan-Dan;WANG Rui-Feng;HAO Li;LIU Gui-Ling(Department of Nephrology,The Second Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院肾内科,合肥230601

出　　处：《中国血液净化》2018年第7期446-449,共4页Chinese Journal of Blood Purification

摘　　要：目的观察中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)在腹膜透析相关性感染发生中的临床意义。方法选取2012年1月~2016年12月在安徽医科大学第二附属医院因腹膜透析相关性感染住院的患者,与同期入院的腹膜透析非感染的患者相比较。纳入指标包括年龄、性别、有无糖尿病病史、血红蛋白、血清白蛋白、血钾、血镁、血钙(校正血钙)、血磷、三酰甘油、总胆固醇、超敏C反应蛋白及NLR,分析上述指标与腹膜透析相关性感染的关系。结果共纳入研究对象211例,两组患者年龄(52.66±14.53比52.35±15.07,t=0.150,P=0.881)、性别(男性数54比51,χ~2=2.099,P=0.147)、有无糖尿病病史(有糖尿病12比12,χ~2=0.451,P=0.502)、血红蛋白(91.05±20.04比93.77±18.25g/L,t=-1.017,P=0.311)、血钾(3.59±0.75比3.77±0.72mmol/,t=-1.696,P=0.091)、三酰甘油[1.21(0.82,1.58)比1.19(0.81,1.66)mmol/L,Z=-0.179,P=0.919]及总胆固醇[(4.44±1.09)比(4.67±1.06)mmol/L,t=0.158,P=0.784]无统计学差异;感染组NLR[6.29(3.85,10.35)比2.71(2.70,3.78),Z=-8.321,P=0.000]、血钙[2.43(2.28,2.61)比2.34(2.18,2.44)mmol/L,Z=-3.164,P=0.002]及超敏C反应蛋白[(66.67±64.53)比(6.57±10.86)mg/L,t=8.833,P=0.000]高于对照组,而血清白蛋白[(26.38±6.79)比(29.59±5.30)g/L,t=-3.742,P=0.000]、血镁[(0.72±0.17)比(0.79±0.16)mmol/L,t=-3.167,P=0.002]、血磷[1.26(0.98,1.50)比1.31(1.13,1.64)mmol/L,Z=-2.040,P=0.041]低于对照组。Spearman多因素相关分析提示腹膜透析相关性感染与NLR(r=0.574,P=0.000)、血钙(r=0.218,P=0.001)及超敏C反应蛋白(r=0.188,P=0.006)呈正相关;而与血清白蛋白(r=-0.224,P=0.001)、血镁(r=-0.224,P=0.001)、血磷(r=-0.141,P=0.041)呈负相关。Logistic回归分析提示NLR及血清白蛋白与腹膜透析相关性感染有密切关系,高水平的NLR和较低的血清白蛋白是其危险因素。结论腹膜透析相关性感染患者的中性粒细胞与淋巴细胞比值、血钙及超敏C反应蛋白水平普Purpose To observe the clinical significance of neutrophil-to-lymphocyte ratio （NLR） in peritoneal dialysis（PD） related infection. Methods Between Jan, 2012 and Dec,2016, patients who were hospitalized with peritoneal dialysis related infection in The Second Hospital of Anhui Medical University were compared with those peritoneal dialysis patients who were admitted to the hospital with non- infection during the same period. There were 119 peritoneal dialysis related infection patients and 92 peritoneal dialysis patients without infection in our study. We measured age, gender, history of diabetes, hemoglobin, serum albumin, serum potassium, serum magnesium, corrected serum calcium, serum phosphorus, triglycerides, total cholesterol, hs-CRP and NLR, and analyzed the relationship between the above indicators and the incident of peritoneal dialysis related infection. Results There were 211 cases in the study, and there were no statistical difference in the age（52.66±14.53 vs 52.35±15.07y, t=0.150, P=0.881）, gender（male 54 vs 51, χ2=2.099, P=0.147）, history of diabetes（12 vs 12, χ2=0.451, P=0.502）, the level of hemoglobin（91.05±20.04 vs 93.77±18.25g/L, t=-1.017, P=0.311）, serum potassium（3.59±0.75 vs 3.77±0.72mmol/L, t=-1.696, P=0.091）, triglycerides（1.21（0.82,1.58） vs 1.19（0.81,1.66）mmol/L, Z=-0.179, P=0.919） and total cholesterol（4.44±1.09 vs 4.67±1.06mmol/L, t=0.158, P=0.784） of the two groups. The NLR（6.29（3.85,10.35） vs 2.71（2.70,3.78）, Z=-8.321, P=0.000） as well as corrected serum calcium（2.43（2.28,2.61） vs 2.34（2.18,2.44）mmol/L, Z=-3.164, P=0.002） and hs-CRP（66.67±64.53 vs 6.57±10.86mg/L, t=8.833, P=0.000） were significantly higher in the infection group, while the serum albumin（26.38±6.79 vs 29.59±5.30g/L, t=-3.742, P=0.000）, serum magnesium（0.72±0.17 vs 0.79±0.16mmol/L, t=-3.167, P=0.002） and serum phosphorus（1.26（0.98,1.50） vs 1.31（1.13,1.64）mmol/L, Z=-2.040, P=0.041） were significantly lower than the

关 键 词：中性粒细胞与淋巴细胞比值 腹膜透析 感染 

分 类 号：R459.5[医药卫生—治疗学]