单核细胞高密度脂蛋白比值与慢性肾脏病1-3期老年患者预后的相关性分析  

Correlation analysis of monocyte to high density lipoprotein ratio and prognosis of elderly patients with chronic kidney disease stage 1-3

作　　者：杨钢 刘静[2] Yang Gang;Liu Jing(Department of Nephrology,Red Cross Hospital of Wuhan City,Wuhan,Hubei,430024,P.R.China;Department of Neph-rology,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,430000,P.R.China)

机构地区：[1]武汉市红十字会医院肾内科,湖北武汉430024 [2]华中科技大学同济医学院附属协和医院肾内科,湖北武汉430000

出　　处：《老年医学与保健》2022年第4期726-731,共6页Geriatrics & Health Care

摘　　要：目的 探讨单核细胞高密度脂蛋白比值(MHR)与慢性肾脏病(CKD)1-3期老年患者肾脏预后的关系。方法 回顾性纳入2016年3月—2017年2月收治并于武汉市红十字会医院规律随访的298例老年CKD 1-3期患者为研究对象。根据MHR水平将患者分为MHR>0.368组和MHR≤0.368组,收集并比较2组患者的临床和实验室检查资料。对所有患者进行随访,通过Kaplan-Meier生存曲线比较2组患者的中位肾脏生存时间,单因素和多因素分析明确影响肾脏预后不良的危险因素。结果 同MHR≤0.368组患者相比,MHR>0.368组患者年龄更大、CKD3期比例更高、高血压和高脂血症比例更高、平均动脉压更高、白细胞更高、血尿酸更高、血肌酐更高、血尿素氮和胱抑素C更高、低密度脂蛋白(LDL)更高,而血红蛋白更低(均P<0.05)。Kaplan-Meier生存分析结果提示,MHR>0.368组中位肾脏生存期显著短于MHR≤0.368组(36个月vs 54个月,P<0.001)。多因素分析提示,CKD分期过高、贫血、24 h尿蛋白定量>1 g/d、LDL升高以及MHR>0.368是患者肾脏预后不良的独立危险因素。结论 高水平MHR可能是CKD1-3期老年患者肾脏预后不良的独立危险因素。Objective To investigate the relationship between monocyte to high-density cholesterol lipoprotein ratio(MHR) and renal prognosis in elderly patients with chronic kidney disease(CKD) stage 1-3.Methods A total of 298 elderly patients with CKD stages 1-3 who were treated and regularly followed up in Red Cross Hospital of Wuhan City from March 2016 to February 2017 were retrospectively enrolled.According to the MHR level,they were divided into MHR>0.368 group and MHR≤0.368 group.The clinical and laboratory data of patients of the two groups were collected and compared.All patients were followed up.The median renal survival time of the two groups was compared by Kaplan-Meier survival curve.Univariate and multivariate analysis were used to identify the risk factors for poor renal prognosis.Results Compared with the patients in the MHR≤0.368 group,the patients in the MHR>0.368 group had older age,higher proportion of CKD stage 3,higher proportion of hypertension and hyperlipidemia,higher mean arterial pressure,higher white blood cells,higher blood uric acid,higher blood creatinine,higher blood urea nitrogen and cystatin C,higher low-density lipoprotein(LDL),and lower hemoglobin(all P<0.05).The Kaplan-Meier curve analysis showed that the median renal survival of the MHR>0.368 group was significantly shorter than that of the MHR≤0.368 group(36 months vs 54 months,P<0.001).Multivariate analysis showed that advanced CKD stage,anemia,24 h urine protein quantification>1 g/d,elevated LDL and MHR>0.368 were independent risk factors for poor renal prognosis.Conclusion High level of MHR may be an independent risk factor for poor renal prognosis in elderly patients with CKD stages 1-3.

关 键 词：老年 单核细胞高密度脂蛋白比值 慢性肾脏病 预后 

分 类 号：R692[医药卫生—泌尿科学]