NLR在腹膜透析相关性腹膜炎中的临床研究  

Clinical study on NLR in peritoneal dialysis-associated peritonitis

作　　者：李啟俊 曾蕾[1] 罗远标[1] 李华友[1] 黄少珍[1] Li Qijun;Zeng Lei;Luo Yuanbiao;Li Huayou;Huang Shaozhen(Department of Nephrology,Zhanjiang Central People's Hospital,Zhanjiang,Guangdong 524037,China)

机构地区：[1]湛江中心人民医院肾内科,广东湛江524037

出　　处：《齐齐哈尔医学院学报》2024年第5期430-433,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨腹膜透析患者中性粒细胞计数与淋巴细胞计数比值(neutrophil-to-lymphocyte ratio,NLR)对腹膜透析相关性腹膜炎(peritoneal dialysis-associated peritonitis,PDAP)的临床价值。方法选择2019年1月—2021年12月本院肾内科住院的185例腹膜透析患者作为研究对象,按患者症状、腹水浑浊程度及腹水白细胞数分为腹膜炎组(32例)和非腹膜炎组(153例)两组。应用Spearman相关分析腹膜透析相关性腹膜炎与各因素之间的关系,采用二分类Logistic回归分析腹膜透析相关性腹膜炎发生的危险因素,应用ROC曲线评估NLR对腹膜透析相关性腹膜炎的预测价值。结果两组患者在白细胞计数、中性粒细胞计数、淋巴细胞计数、NLR、血清白蛋白、尿酸、血钾、血磷、钙磷乘积、低密度脂蛋白、胆固醇、腹透液白细胞数、降钙素原比较,差异具有统计学意义(P<0.05);NLR、腹透液中白细胞数与腹膜透析相关性腹膜炎呈正相关;多因素Logistic分析结果显示,腹透液中白细胞数(OR=1.073,95%CI 1.028~1.120,P<0.05)为PDAP独立危险因素;ROC曲线分析结果显示,NLR预测腹膜透析相关性腹膜炎曲线下面积为0.794(95%CI 0.703~0.885,P<0.05),当NLR截断值为2.70,预测慢性肾脏病腹透患者发生腹膜炎的敏感度和特异度分别为87.5%和60.1%。结论NLR预测腹膜透析患者发生腹膜炎具有较好的临床应用价值,下调NLR有利于控制腹膜炎。Objective To investigate the clinical value of neutrophil to lymphocyte ratio(NLR)in peritoneal dialysis patients for peritoneal dialysis-associated peritonitis(PDAP).Methods 185 patients hospitalized in Zhanjiang Central People's Hospital and received peritoneal dialysis from January,2019 to December,2021 were enrolled as the study subjects,they were divided into the peritonitis group(n=32)and the non-peritonitis group(n=153)according to symptoms,degree of ascites turbidity,and leukocyte count in ascites.Spearman correlation analysis was used to analyze the relationship between peritoneal dialysis-related peritonitis and various factors,binary Logistic regression was used to analyze the risk factors of peritoneal dialysis-related peritonitis,and ROC curve was used to evaluate the predictive value of NLR for peritoneal dialysis-related peritonitis.Results There were statistically significant differences in leukocyte count,neutrophil count,lymphocyte count,NLR,serum albumin,uric acid,blood potassium,blood phosphorus,calcium-phosphorus product,low density lipoprotein,cholesterol,leukocyte count in abdominal permeate fluid and procalcitonin between the two groups(P<0.05).NLR,leukocyte count in peritoneal dialysate were positively correlated with peritoneal dialysis-related peritonitis.Multivariate Logistic analysis showed that white blood cell count(OR=1.073,95%CI 1.028~1.120,P<0.05)was an independent risk factor for PDAP.ROC curve analysis results showed that the area under the curve predicted by NLR was 0.794(95%CI 0.703~0.885,P<0.05),and when the NLR cut-off value was 2.70,the sensitivity and specificity for predicting peritonitis in patients with chronic kidney disease were 87.5%and 60.1%,respectively.Conclusions NLR has good clinical value in predicting peritonitis in patients with chronic kidney disease,and down-regulating NLR is beneficial to control peritonitis.

关 键 词：腹膜透析相关性腹膜炎 中性粒细胞与淋巴细胞比值 腹膜透析 

分 类 号：R692.5[医药卫生—泌尿科学]