PLR和NLR与血液透析患者腹主动脉钙化的相关研究  

Study on the Relationship between Platelet/lymphocyte Ratio,Neutrophil/lymphocyte Ratio and Abdominal Aortic Calcification in Hemodialysis Patients

作　　者：董平 吴雪平[1] 陈卫东 DONG Ping;WU Xueping;CHEN Weidong(The First Affiliated Hospital of Bengbu Medical College,Anhui 233000,China)

机构地区：[1]蚌埠医学院第一附属医院,233000

出　　处：《医学研究杂志》2022年第6期140-144,共5页Journal of Medical Research

基　　金：蚌埠医学院自然科学基金资助项目(BYKY1775)。

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)、中性粒细胞/淋巴细胞比值(neutrophil lymphocyte ratio,NLR)与腹主动脉钙化(abdominal aortic calcification,AAC)的相关研究及应用价值。方法连续收集2020年5月~2021年3月在蚌埠医学院第一附属医院行规律血液透析的114例患者临床资料。根据腹部侧位平片检测AAC的情况,将研究对象分为AAC组(n=70)和非AAC组(n=44),并对两组一般指标及血液指标行相关统计学分析。结果AAC组患者糖尿病、冠心病患病率较非AAC组患者高;年龄、透析龄、PLR、NLR、C反应蛋白水平也高于非AAC组患者,差异均有统计学意义(P<0.05)。年龄(OR=1.057,95%CI:1.012~1.104,P=0.012)、NLR(OR=1.420,95%CI:1.069~1.885,P=0.015)、PLR(OR=1.007,95%CI:1.001~1.014,P=0.036)是AAC的独立危险因素。AAC与年龄(r=0.380,P<0.001)、糖尿病(r=0.242,P=0.010)、血磷(r=0.195,P=0.038)、CRP(r=0.231,P<0.013)、PLR(r=0.423,P<0.001)、NLR(r=0.360,P<0.001)呈正相关。PLR与年龄(r=0.321,P<0.001)、CRP(r=0.461,P<0.001)、NLR(r=0.360,P<0.001)呈正相关。NLR与年龄(r=0.284,P=0.002)、CRP(r=0.552,P<0.001)、PLR(r=0.564,P<0.001)呈正相关。PLR预测MHD患者发生AAC的曲下面积为0.778(P<0.001),截断值为114.87,敏感度为83%,特异性为66%;NLR预测MHD患者发生AAC的曲下面积为0.769(P<0.001),截断值为3.37,敏感度为80%,特异性为68%。结论PLR、NLR与炎性指标相关,作为ACC的预测特异性不高,受多种因素影响,临床应用价值具有局限性。Objective To explore the correlation between platelet/lymphocyte ratio(PLR),neutrophil/lymphocyte ratio(NLR))and calcified(AAC)of abdominal aorta in patients with maintenance hemodialysis(MHD)and its application value.Methods The clinical data of 114 patients undergoing regular hemodialysis in the first affiliated Hospital of Bengbu Medical College from May 2020 to March 2021 were collected.According to the detection of AAC by abdominal lateral plain film,the subjects were divided into two groups:AAC group(n=70)and non-AAC group(n=44).The general and blood indexes of the two groups were statistically analyzed.Results The prevalence of diabetes and coronary heart disease in the AAC group was higher than that in the non-AAC group,and the age,dialysis age,PLR,NLR and C-reactive protein levels in the AAC group were also higher than those in the non-AAC group.There were significant differences in the above indexes(P<0.05).Age(OR=1.057,95%CI:1.012-1.104,P=0.012),NLR(OR=1.420,95%CI:1.069-1.885,P=0.015),PLR(OR=1.007,95%CI:1.001-1.014,P=0.036)were independent risk factors for AAC.AAC was positively correlated with age(r=0.380,P<0.001),diabetes(r=0.242,P<0.010),P(r=0.195,P<0.038),CRP(r=0.231,P<0.013),PLR(r=0.423,P<0.001)and NLR(r=0.360,P<0.001).PLR was positively correlated with age(r=0.321,P<0.001),CRP(r=0.461,P<0.001)and NLR(r=0.360,P<0.001).NLR was positively correlated with age(r=0.284,P<0.002),CRP(r=0.552,P<0.001)and PLR(r=0.564,P<0.001).PLR predicted AAC in MHD patients with a curved area of 0.778(P<0.001),a cutoff value of 114.87,a sensitivity of 83%,and a specificity of 66%.NLR predicted AAC in MHD patients with an area under curvature of 0.769(P<0.001),a cutoff value of 3.37,a sensitivity of 80%,and a specificity of 68%.Conclusion PLR and NLR are related to inflammatory markers,but the specificity of predicting ACC is not high,and it is affected by many factors,so its clinical application value is limited.

关 键 词：维持性血液透析 血小板/淋巴细胞比值 中性粒细胞/淋巴细胞比值 血管钙化 炎性状态 

分 类 号：R692.5[医药卫生—泌尿科学]