外周血NRR、LRR、MRR、NLR及MLR相关参数对慢性肾脏病进展的预测价值  

Predictive value of peripheral blood NRR,LRR,MRR,NLR and MLR related parameters on the progression of chronic kidney disease

作　　者：李全[1] 沈建江[1] 李鹏飞[1] LI Quan;SHEN Jianjiang;LI Pengfei(Department of Clinical Laboratory,Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Provincial Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]江苏省中医院/南京中医药大学附属医院检验科,江苏南京210029

出　　处：《现代医学》2023年第11期1578-1583,共6页Modern Medical Journal

基　　金：国家中医临床研究基地开放课题资助(JD2022SZ11)。

摘　　要：目的:探讨外周血中性粒细胞与红细胞比率(NRR)、淋巴细胞与红细胞比率(LRR)、单核细胞与红细胞比率(MRR)、中性粒细胞与淋巴细胞比率(NLR)及单核细胞与淋巴细胞比率(MLR)对不同分期慢性肾脏病的诊断价值。方法:收集2021年2月至2022年2月江苏省中医院肾内科收治入院的148例慢性肾脏病患者及50例健康体检者作为训练集,根据肾小球滤过率(eGFR)将慢性肾脏病分为3期,其中慢性肾脏病3期43例(30<eGFR≤60),慢性肾脏病4期56例(15<eGFR≤30),慢性肾脏病5期49例(eGFR≤15)。入院后慢性肾脏病3期收治入院以治疗原发病为主,慢性肾脏病4期收治入院以治疗并发症为主,慢性肾脏病5期开始透析治疗。比较训练集正常对照组和不同分期的慢性肾脏病患者外周血NRR、LRR、MRR、NLR及MLR值,进一步绘制受试者工作曲线(ROC曲线),评价所有指标对不同分期的慢性肾脏病诊断价值,并分析各指标在慢性肾脏病患者住院治疗前后的差异。另收集20例临床确诊慢性肾脏病患者及30例健康者作为验证集,对联合诊断的灵敏度和特异度进行验证。结果:慢性肾脏病患者外周血NRR、LRR、MRR、NLR及MLR显著高于正常对照组(P<0.05)。随着eGFR数值的降低,NRR、LRR、MRR、NLR及MLR数值均逐渐升高,差异具有统计学意义(P<0.05),治疗前后NRR、LRR、MRR、NLR及MLR差异具有统计学意义(P<0.05)。ROC曲线结果表明,NRR、LRR、MRR、NLR、MLR及联合诊断对CKD具有较好的诊断价值。验证集数据表明,NRR、LRR、MRR、NLR及MLR联合检测CKD的灵敏度和特异度均满足要求。结论:NRR、LRR、MRR、NLR、MLR对不同分期慢性肾脏病进展诊断具有一定的应用价值,并且单独及联合检测对慢性肾脏病治疗效果监测均具有参考意义。Objective:To explore the diagnostic value of peripheral blood neutrophil to red blood cell ratio(NRR),lymphocyte to red blood cell ratio(LRR),monocyte to red blood cell ratio(MRR),neutrophil to lymphocyte ratio(NLR)and monocyte to lymphocyte ratio(MLR)in different stages of chronic kidney disease(CKD).Methods:From February 2021 to February 2022,148 patients with CKD and 50 healthy physical examiners(control group)admitted to the Department of Nephrology of Jiangsu Provincial Hospital of Chinese Medicine were collected as a training set.According to the estimated glomerular filtration rate(eGFR),CKD was divided into three stages,including 43 patients with CKD stage 3(30<eGFR≤60),56 with stage 4(15<eGFR≤30),and 49 with stage 5(eGFR≤15).After admission,the treatment for patients with CKD stage 3 was mainly focused on the primary disease,the treatment for stage 4 was mainly focused on the complications,and the dialysis treatment was started in CKD with stage 5.The values of NRR,LRR,MRR,NLR and MLR in patients with CKD at different stages and the control group were compared.The receiver operating characteristic curve(ROC curve)was drawn to evaluate the diagnostic value of all the indicators for patients with CKD at different stages.The differences of all the indicators in patients before and after hospitalization were also analyzed.Another 20 patients with clinically confirmed CKD and 30 healthy people were collected as verification set to verify the sensitivity and specificity of the combined diagnosis.Results:The values of NRR,LRR,MRR,NLR and MLR of peripheral blood from patients with CKD were significantly higher than those of normal controls(P<0.05).In addition,as the values of eGFR decreased,the values of NRR,LRR,MRR,NLR,and MLR gradually increased,and the difference was statistically significant(P<0.05).The results also showed significant difference before and after treatment in the values of NRR,LRR,MRR,NLR,and MLR in patients with CKD(P<0.05).ROC curve analysis showed that NRR,LRR,MRR,NLR,MLR and combine

关 键 词：慢性肾脏病 中性粒细胞与红细胞比率 淋巴细胞与红细胞比率 单核细胞与红细胞比率 中性粒细胞与淋巴细胞比率 单核细胞与淋巴细胞比率 

分 类 号：R692[医药卫生—泌尿科学]