维持性血液透析患者中性粒细胞与淋巴细胞比值对心脏瓣膜钙化的影响  

Effects of neutrophils-to-lymphocytes ratio on heart valve calcification in maintenance hemodialysis patients

作　　者：张明明 张玉颖 李天宇 陈丹 张森[1] 王雪荣[1] 郝丽[1] 王德光[1] ZHANG Ming-ming;ZHANG Yu-ying;LI Tian-yu;CHEN Dan;ZHANG Sen;WANG Xue-rong;HAO Li;WANG De-guang(Department of Nephrology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,Anhui,China)

机构地区：[1]安徽医科大学第二附属医院肾脏内科,合肥230601

出　　处：《医学研究生学报》2020年第3期280-284,共5页Journal of Medical Postgraduates

基　　金：安徽省公益性技术应用研究联动计划项目(1604f0804021);安徽医科大学2019年度校科研基金(2019xkj140)。

摘　　要：目的心血管疾病(CVD)是血液透析(HD)终末期肾病(ESRD)患者发病及死亡的主要原因。文中探讨分析维持性血液透析患者(MHD)中性粒细胞与淋巴细胞比值(NLR)与心脏瓣膜钙化(CVC)的关系,为CVC的防治提供依据。方法回顾性分析安徽医科大学第二附属医院135例MHD患者人口学资料、相关临床指标及实验室检查结果,计算NLR值;采用超声心动图检测患者CVC发病情况,并分为钙化组和非钙化组。分析NLR值与MHD患者发生CVC的关系,并采用Logistic回归分析法探讨CVC发生的独立危险因素。结果本组135例MHD患者中CVC患者59例(43.7%)。与非钙化组相比,心脏瓣膜钙化组患者年龄、透析龄、超敏C反应蛋白(Hs-CRP)、ALP、NLR均显著升高,差异均有统计学意义(P<0.05);相关性分析显示,CVC与透析龄、年龄、Hs-CRP、ALP及NLR呈正相关(P<0.05);Logistic回归分析结果显示,透析龄(OR=1.017,P=0.030)、ALP(OR=1.001,P=0.043)和NLR>5.02(OR=17.709,P=0.046)是MHD患者心脏瓣膜钙化的独立危险因素。结论维持性血液透析患者心瓣膜钙化发生率高。NLR是维持性血液透析患者心瓣膜钙化的独立危险因素。Objective Cardiovascular disease(CVD)is the main cause of morbidity and mortality in patients with hemodialysis(HD)end-stage renal disease(ESRD).This paper analyzes and discusses the relationship between neutrophils-to-lymphocytes ratio(NLR)and heart valve calcification(CVC)in maintenance hemodialysis(MHD)patients to provide theoretical basis for the prevention and treatment of CVC.Methods The demographic data,relevant clinical indicators and laboratory examination results of 135 patients with MHD in the Second Hospital of Anhui Medical University were retrospectively analyzed to calculate the NLR value.Echocardiography was used to detect the incidence of CVC in the patients,and they were divided into calcification group and non-calcification group.The correlation between NLR value and CVC in MHD patients was analyzed,and the independent risk factors of CVC were discussed by using Logistic regression.Results Among the 135 MHD patients,CVC was found in 59 cases(43.7%).Compared with the non-calcification group,patients in the calcification group showed significant increases in age,dialysis age,high-sensitivity c-reactive protein(HsCRP),ALP and NLR,with statistically significant differences(P<0.05).Correlation analysis showed that CVC was positively correlated with dialysis age,age,HsCRP,ALP and NLR(P<0.05).Logistic regression showed that dialysis age(OR=1.017,P=0.030),ALP(OR=1.001,P=0.043)and NLR>5.02(OR=17.709,P=0.046)were independent risk factors for heart valve calcification in MHD patients.Conclusion The incidence of heart valve calcification is high in MHD patients,and NLR is an independent risk factor for it.

关 键 词：维持性血液透析 心脏瓣膜钙化 中性粒细胞与淋巴细胞比值 

分 类 号：R541[医药卫生—心血管疾病]