血清T淋巴细胞亚群及PLR、MLR、NLR对尿毒症腹膜透析相关性腹膜炎患者的预测价值  

The Predictive Value of Serum T Lymphocyte Subsets,PLR,MLR and NLR for Peritoneal Dialysis Peritonitis

作　　者：李怡素 贺雪[2] 徐勇[1] 刘骏[1] 胡静[1] 刘纪实[1] LI Yi-su;HE Xue;XU Yong(Department of Nephrology,the Third Xiangya Hospital of Central South University,Changsha Hunan 410013)

机构地区：[1]中南大学湘雅三医院肾内科,湖南长沙410013 [2]中南大学湘雅三医院健康管理中心,湖南长沙410013

出　　处：《医学临床研究》2023年第8期1128-1131,1135,共5页Journal of Clinical Research

基　　金：湖南省卫生健康委基金(编号:202103050563)。

摘　　要：【目的】探讨血清T淋巴细胞亚群及中性粒细胞/淋巴细胞比值(neutrophil-to-lym-phocyteratio,NLR)、淋巴细胞/单核细胞比值(lymphocyte-to-monocyte ratio,MLR)、血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)对尿毒症腹膜透析相关性腹膜炎(PDAP)患者的预测价值。【方法】选取2018年3月至2022年3月在本院住院治疗的119例尿毒症腹膜透析(PD)患者,根据是否合并PDAP分为腹膜炎组和非腹膜炎组。比较两组T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、炎症指标水平,分析各指标的相关性及其对PDAP的预测价值。【结果】腹膜炎组CD4^(+)、CD4^(+)/CD8^(+)均高于非腹膜炎组,CD8^(+)、T淋巴细胞计数均低于非腹膜炎组,差异均有统计学意义(P<0.05);两组T淋巴细胞百分比比较,差异无统计学意义(P>0.05);腹膜炎组NLR、MLR、PLR、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、降钙素原(procalcitonin,PCT)均高于非腹膜炎组,差异均有统计学意义(P<0.05)。CD4^(+)/CD8^(+)与NLR呈负相关(r=-0.327,P<0.05),与MLR、hs-CRP呈正相关(r=0.875、r=0.306,P<0.05)。血清CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、PLR、NLR、MLR、hs-CRP、ESR、PCT预测PDAP的曲线下面积(AUC)分别为0.711、0.365、0.700、0.720、0.886、0.931、0.883、0.802、0.737。【结论】血清T淋巴细胞亚群及PLR、MLR、NLR、hs-CRP、ESR、PCT对PDAP均具有较好的预测价值,其中NLR、MLR特异性最强,具有较高的临床参考价值。【Objective】To investigate the predictive value of serum T lymphocyte subsets,neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR)and platelet-to-lymphocyte ratio(PLR)ratio for peritoneal dialysis-associated peritonitis(PDAP)diagnosis.【Methods】A total of 119 peritoneal dialysis-associated patients who were hospitalized in our hospital from March 2018 to March 2022 were enrolled and divided into the peritonitis group and non-peritonitis group.The differences and correlations of T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and various inflammatory indicators in each group were compared,and their predictive value for peritoneal dialysis peritonitis was analyzed.【Results】The CD4^(+)and CD4^(+)/CD8^(+)in the peritonitis group were higher than those in the non-peritonitis group,and the differences were statistically significant(P<0.05).CD8^(+)and T lymphocyte counts in the peritonitis group were lower than those in the non-peritonitis group,and the differences were statistically significant(P<0.05).There was no significant difference in the percentage of T lymphocytes between the two groups(P>0.05).However,NLR,MLR,PLR,hs-CRP,erythrocyte sedimentation rate(ESR)and procalcitonin(PCT)in the peritonitis group were higher than those in the non-peritonitis group,and the differences were statistically significant(P<0.05).The CD4^(+)/CD8^(+)was negatively correlated with NLR(r=-0.327,P<0.05),positively correlated with MLR(r=0.875,P<0.05),and positively correlated with hs-CRP(r=0.306,P<0.05).The AUC of serum CD4^(+),CD8^(+),CD4^(+)/CD8^(+),PLR,NLR,MLR,hs-CRP,ESR,and PCT in predicting peritoneal dialysis-related peritonitis were 0.711,0.365,0.700,0.720,0.886,0.931,0.883,0.802,and 0.737,respectively.【Conclusion】Serum T lymphocyte subsets,PLR,MLR,NLR,hs-CRP,ESR and PCT have good predictive value for peritoneal dialysis-associated peritonitis.Of which,NLR and MLR have the strongest specificity and higher clinical reference value.

关 键 词：腹膜炎 尿毒症 腹膜透析 T淋巴细胞亚群 

分 类 号：R656.41[医药卫生—外科学]