中性粒细胞/淋巴细胞比对脑血管造影后造影剂肾病的早期诊断价值  

Value of Neutrophil-to-Lymphocyte Ratio in Diagnosis of Contrast-Induced Nephropathy after Cerebral Angiography

作　　者：戴为正[1] 傅懋林[1] 吴美娜 王双虎[1] 何文钦[1] DAI Wei-zheng;FU Mao-lin;WU Mei-na;WANG Shuang-hu;HE Wen-qin(Department of Neurology,910 th Hospital of the Chinese People’s Liberation Army,Quanzhou 362000,China)

机构地区：[1]中国人民解放军联勤保障部队第九一〇医院神经内科

出　　处：《实用临床医学（江西）》2019年第11期1-3,18,共4页Practical Clinical Medicine

基　　金：泉州市科技计划项目([2014]Z52)

摘　　要：目的探讨血清中性粒细胞/淋巴细胞比(neutrophil-to-lymphocyte ratio,NLR)对行脑血管造影后出现造影剂肾病(contrast-induced nephropathy,CIN)的早期预测价值。方法选取200例行脑血管造影的患者,根据是否出现CIN将其分为CIN组(n=24)和非CIN组(n=176)。从2组术前的临床资料中,纳入患者的年龄、性别、吸烟、糖尿病、高血压病、血脂水平、造影剂剂量、肌酐、中性粒细胞计数、淋巴细胞计数、NLR、糖化血红蛋白等进行分析,并采用受试者工作特征曲线下面积(AUROC)评估NLR对CIN的诊断价值。结果高龄,女性,术前糖尿病及高血压病,造影剂剂量大,中性粒细胞计数、NLR及糖化血红蛋白高,淋巴细胞计数低是术后出现CIN的危险因素。NLR对术后出现CIN的AUC为0.786[95%CI为0.696~0.877],根据ROC曲线确定NLR的最佳诊断临界值为3.71,其敏感度为71.3%,特异性为69.4%。结论NLR可作为脑血管造影患者术后发生CIN的一个早期预警标志物,术前NLR≥3.71患者需高度警惕术后CIN的可能。Objective To investigate the value of serum neutrophil-to-lymphocyte ratio(NLR)in early prediction of contrast-induced nephropathy(CIN)after cerebral angiography.Methods Totally 200 patients undergoing cerebral angiography were divided into CIN group(n=24)and non-CIN group(n=176).Clinical data were analyzed,including age,gender,smoking history,diabetes,hypertension,blood lipid level,contrast medium dose,creatinine concentration,neutrophil count,lymphocyte count,NLR and glycolated hemoglobin level.The diagnostic value of NLR for CIN was assessed using the area under the receiver operating characteristic curve(AUROC).Results Advanced age,female,preoperational diabetes,hypertension,large dose of contrast medium,high neutrophil count,high NLR,high glycolated hemoglobin level and low lymphocyte count were the risk factors for CIN after cerebral angiography.The AUC of NLR for CIN was 0.786(95%CI 0.696-0.877).The optimal diagnostic threshold was defined at 3.71 according to the ROC curve,with the sensitivity of 71.3%and the specificity of 69.4%.Conclusion NLR can be used as an early indicator of CIN after cerebral angiography.Preoperational NLR≥3.71 is highly associated with the possibility of postoperative CIN.

关 键 词：中性粒细胞/淋巴细胞比 造影剂肾病 脑血管造影 预测 

分 类 号：R741[医药卫生—神经病学与精神病学] R692[医药卫生—临床医学]