维持性腹膜透析患者外周血NLR PLR HGB水平变化及其与钙磷代谢异常和全因病死率的关系  

Changes in Peripheral Blood NLR PLR and HGB Levels in Maintenance Peritoneal Dialysis Patients and Their Relationship with Calcium-Phosphorus Metabolism Abnormalities and All-Cause Mortality

作　　者：梅吉本 何静[1] 陈忠辉[1] 束长东 MEI Jiben;HE Jing;CHEN Zhonghui(Xuancheng People's Hospital,Anhui Xuancheng 242000,China)

机构地区：[1]安徽省宣城市人民医院肾内科,安徽宣城242000

出　　处：《河北医学》2024年第1期93-98,共6页Hebei Medicine

基　　金：2020年度安徽省自然科学基金项目,(编号:2008085QH407)。

摘　　要：目的:探究维持性腹膜透析患者外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、血红蛋白(HGB)水平变化及其与钙磷代谢异常和全因病死率的关系。方法:选取2019年3月至2022年6月收治的维持性腹膜透析患者206例,评估患者是否存在钙磷代谢异常,分为异常组和正常组,比较两组外周血NLR、PLR、HGB水平,分析NLR、PLR、HGB与血钙、血磷水平相关性;随访至2022年12月,以全因病死为终点事件,分为病死组和存活组,比较两组外周血NLR、PLR、HGB水平,并用受试者工作特征(ROC)曲线评价NLR、PLR、HGB对患者全因病死的预测价值。结果:异常组外周血NLR、PLR及血磷水平高于正常组,血钙水平低于正常组(P<0.05);但两组年龄、性别、文化程度、原发疾病、透析时间及外周血HGB水平的比较,差异无统计学意义(P>0.05)。维持性血液透析老年患者外周血NLR、PLR与血钙水平呈负相关,与血磷水平呈正相关(P<0.05);而HGB与血钙、血磷水平无明显相关性(P>0.05)。病死组透析时间长于存活组,外周血NLR、PLR及血磷水平高于存活组,血钙水平低于存活组(P<0.05);但两组年龄、性别、文化程度、原发疾病及外周血HGB水平的比较,差异无统计学意义(P>0.05)。ROC曲线分析结果显示,外周血NLR、PLR预测患者全因病死的曲线下面积(AUC)分别为0.777(95%CI:0.688~0.866)、0.781(95%CI:0.668~0.895)。结论:维持性腹膜透析患者钙磷代谢异常与外周血NLR、PLR水平相关,且上述指标对患者全因病死具有一定的预测价值。Objective:To explore the changes in peripheral blood neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and hemoglobin(HGB)levels in maintenance peritoneal dialysis(PD)patients and their relationship with calcium-phosphorus metabolism abnormalities and all-cause mortality.Methods:A total of 206 maintenance PD patients admitted from March 2019 to June 2022 were selected.Patients were assessed for the presence of calcium-phosphorus metabolism abnormalities and divided into abnormal and normal groups.Peripheral blood NLR,PLR,and HGB levels were compared between the two groups.The correlation between NLR,PLR,HGB,and blood calcium and phosphorus levels was analyzed.Follow-up was conducted until December 2022,with all-cause mortality as the endpoint event.Patients were divided into the death group and the survival group,and peripheral blood NLR,PLR,and HGB levels were compared.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of NLR,PLR,and HGB for all-cause mortality.Results:In the abnormal group,peripheral blood NLR,PLR,and blood phosphorus levels were higher,while blood calcium levels were lower than those in the normal group(P<0.05).However,there were no statistically significant differences in age,gender,educa-tion level,primary disease,dialysis time,and peripheral blood HGB levels between the two groups(P>0.05).In elderly patients undergoing maintenance hemodialysis,peripheral blood NLR and PLR were negative-ly correlated with blood calcium levels and positively correlated with blood phosphorus levels(P<0.05).However,HGB showed no significant correlation with blood calcium and phosphorus levels(P>0.05).The dialysis time in the death group was longer than that in the survival group.Peripheral blood NLR,PLR,and blood phosphorus levels were higher,while blood calcium levels were lower in the death group compared to the survival group(P<0.05).However,there were no statistically significant differences in age,gender,educa-tion level,primary disease,and periphera

关 键 词：维持性腹膜透析 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 血红蛋白 钙磷代谢 全因病死 

分 类 号：R459.5[医药卫生—治疗学]