中性粒细胞/淋巴细胞比值和CD4^+/CD8^+比值与狼疮性肾炎患者肾功能及预后的关系  

Relationship between neutrophil/lymphocyte ratio,CD4^+/CD8^+ratio and renal function and prognosis in patients with lupus nephritis

作　　者：鲁冰[1] 任东升[1] 陶雅非[1] LU Bing;REN Dongsheng;TAO Yafei(Department of Nephropathy and Rheumatology,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市中心医院肾病风湿免疫科,河南南阳473000

出　　处：《新乡医学院学报》2020年第10期968-971,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨中性粒细胞/淋巴细胞比值(NLR)、CD4^+/CD8^+比值与狼疮性肾炎(LN)患者肾功能及预后的关系。方法选择2016年1月至2018年10月南阳市中心医院收治的184例LN患者为研究对象,根据入院时估算的肾小球滤过率(eGFR)将患者分为肾功能正常组(eGFR≥90mL·min^-1,n=81)和肾功能不全组(eGFR<90mL·min^-1,n=103),另根据随访1a后肾脏预后情况将患者分为预后良好组(n=156)和预后不良(血肌酐较基线翻倍、进入终末期肾病或行肾脏替代治疗定义为预后不良)组(n=28)。使用全自动血液分析仪进行中性粒细胞、淋巴细胞计数,计算NLR;使用流式细胞仪检测CD4^+、CD8^+细胞亚群,计算CD4^+/CD8^+比值;对肾功能正常组和肾功能不全组、预后良好组和预后不良组患者NLR、CD4^+、CD8^+水平及CD4^+/CD8^+比值进行比较,并分析NLR、CD4^+/CD8^+比值与LN患者肾功能及预后的关系。结果与肾功能正常组比较,肾功能不全组患者中性粒细胞计数增加,淋巴细胞计数减少,NLR增大(P<0.05)。肾功能不全组与肾功能正常组患者CD4^+水平比较差异无统计学意义(P>0.05);肾功能不全组患者CD8^+水平显著高于肾功能正常组,CD4^+/CD8^+比值显著小于肾功能正常组(P<0.05)。与预后良好组比较,预后不良组患者中性粒细胞计数增加,淋巴细胞计数减少,NLR增大(P<0.05)。预后不良组与预后良好组患者CD4^+水平比较差异无统计学意义(P>0.05);预后不良组患者CD8^+水平显著高于预后良好组,CD4^+/CD8^+比值显著小于预后良好组(P<0.05)。Pearson相关性分析结果显示,NLR与LN患者的肾功能及预后呈显著负相关(r=-0.7569、-0.8872,P<0.05),CD4^+/CD8^+比值与LN患者的肾功能及预后呈显著正相关(r=0.3925、0.4342,P<0.05)。结论NLR与LN患者的肾功能及预后呈显著负相关,CD4^+/CD8^+比值与LN患者的肾功能及预后呈显著正相关,NLR、CD4^+/CD8^+比值可作为预测LN患者肾功能及预后的潜在指标�Objective To investigate the relationship between neutrophil/lymphocyte(NLR),CD4^+/CD8^+ratio and renal function,prognosis of patients with lupus nephritis(LN).Methods A total of 184 LN patients admitted to Nanyang Central Hospital from January 2016 to October 2018 were selected as the research subjects.According to the estimated glome-rular filtration rate(eGFR)at admission,the patients were divided into normal renal function group(eGFR≥90 mL·min^-1,n=81)and renal insufficiency group(eGFR<90 mL·min^-1,n=103).In addition,the patients were divided into good prognosis group(n=156)and poor prognosis(the presence of a doubling of serum creatinine from baseline,end-stage renal disease or renal replacement therapy was defined as poor prognosis)group(n=28)according to renal prognosis after one year follow-up.The neutrophils and lymphocytes were counted by automatic blood analyzer,and the NLR was calculated.CD4^+and CD8^+cells were detected by flow cytometry,and the CD4^+/CD8^+ratio was calculated.The NLR,the levels of CD4^+and CD8^+and the CD4^+/CD8^+ratio were compared between the normal renal function group and renal insufficiency group,the good prognosis group and poor prognosis group;and the relationship between NLR,CD4^+/CD8^+ratio and the renal function and prognosis of LN patients was analyzed.Results Compared with the normal renal function group,the neutrophils count increased,the lymphocyte count decreased,and the NLR increased in the renal insufficiency group(P<0.05).There was no significant difference in the CD4^+level between the renal insufficiency group and normal renal function group(P>0.05).The CD8^+level in the renal insufficiency group was significantly higher than that in the normal renal function group,while the CD4^+/CD8^+ratio was significantly lower than that in the normal renal function group(P<0.05).Compared with the good prognosis group,the neutrophils count increased,the lymphocytes count decreased,and the NLR increased in the poor prognosis group(P<0.05).There was no significant differenc

关 键 词：狼疮性肾炎 中性粒细胞 淋巴细胞 肾功能 预后 

分 类 号：R593.242[医药卫生—内科学]