外周血NLR、PLR、CRP检测在老年腹膜透析相关性感染诊断中的价值分析  

Analysis of the diagnostic value of NLR,PLR and CRP in elderly patients with peritoneal dialysis-related infection

作　　者：林蓉宇 陈文[1] LIN Rong-yu;CHEN Wen(Department of Nephrology,the Second Affiliated Hospital of Hainan Medical College,Haikou 570100,Hainan,China)

机构地区：[1]海南医学院第二附属医院肾内科,海南海口570100

出　　处：《川北医学院学报》2022年第6期734-737,共4页Journal of North Sichuan Medical College

基　　金：海南省应用技术研发与示范推广专项(ZDXM2015085)。

摘　　要：目的:探讨外周血中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、C反应蛋白(CRP)诊断老年腹膜透析相关性感染(PDRI)的临床价值。方法:选取250例老年腹膜透析患者为研究对象,根据是否发生PDRI分为PDRI组(n=45)和非PDRI组(n=205)。比较两组患者的一般资料、临床检验指标;多因素Logistic回归分析影响PDRI的独立危险因素;受试者工作特征(ROC)曲线评价NLR、PLR、CRP及三者联合诊断PDRI的临床价值。结果:PDRI组患者血清CRP、降钙素原(PCT)水平及NLR、PLR高于非PDRI组(P<0.05);两组患者性别、年龄、体质量指数(BMI)、肾脏病类型、血红蛋白(Alb)、血清白蛋白(Hb)、血尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,CRP、NLR、PLR是老年PDRI的独立影响因素(P<0.05)。ROC曲线分析显示,NLR、PLR、CRP诊断老年PDRI的AUC值分别为0.887、0.792、0.775,三者联合诊断PDRI的AUC值为0.954,敏感度为95.56%,特异度为81.82%。结论:NLR、PLR、CRP均对诊断老年PDRI有诊断价值,三者联合可提高其诊断效能。Objective:To analyze the clinical value of peripheral blood neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and C-reactive protein(CRP)in the diagnosis of elderly patients with peritoneal dialysis-related infection(PDRI).Methods:250 elderly patients with peritoneal dialysis were selected as the research object.They were divided into two groups according to whether PDRI occurred,45 cases in PDRI group and 205 cases in non PDRI group.The general data and clinical indexes of the two groups were compared,the independent risk factors of PDRI were analyzed by multivariate Logistic regression,and the clinical value of NLR,PLR,CRP and their combination in the diagnosis of PDRI were evaluated by making receiver operating characteristic(ROC)curve.Results:The levels of serum CRP,PCT,NLR and PLR in PDRI group were significantly higher than those in non PDRI group(P<0.05),there was no significant difference in gender,age,body mass index(BMI),type of kidney disease,hemoglobin(ALB),serum albumin(HB),uric acid(UA),total cholesterol(TC)and triglyceride(TG)between the two groups(P>0.05).Multivariate Logistic regression analysis showed that CRP,NLR and PLR were independent influencing factors of elderly PDRI(P<0.05).ROC curve showed that the AUC values of NLR,PLR and CRP in the diagnosis of elderly PDRI were 0.887,0.792 and 0.775,respectively.The AUC value of the three combined diagnosis of PDRI was 0.954,the sensitivity was 95.56%,and the specificity was 81.82%.Conclusion:NLR,PLR and CRP are valuable in the diagnosis of PDRI in elderly patients,and the combination of them can improve the diagnostic efficiency.

关 键 词：腹膜透析相关性感染 C反应蛋白 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 诊断 

分 类 号：R473.5[医药卫生—护理学]