单核细胞、NLR、suPAR在动静脉内瘘狭窄中的作用及其预测价值  

The role of monocytes,NLR,and suPAR in arteriovenous fistula stenosis and their predictive value

作　　者：胡爽 尹娜 蔡娟 傅丽华 彭侃夫 HU Shuang;YIN Na;CAI Juan;FU Lihua;PENG Kanfu(Department of Nephrology,First Affiliated Hospital of Third Military Medical University(Army Medical University),Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院肾内科,重庆400038

出　　处：《免疫学杂志》2024年第12期901-905,共5页Immunological Journal

基　　金：国家自然科学基金(81873606)。

摘　　要：目的本研究旨在探讨单核细胞、中性粒细胞与淋巴细胞比值(NLR)和可溶性尿激酶型纤溶酶原激活物受体(suPAR)与动静脉内瘘狭窄的相关性以及联合使用对预测动静脉内瘘狭窄的价值。方法从陆军军医大学第一附属医院肾脏内科收集了2022年9月30日至2023年9月30日期间经自体动静脉内瘘行维持性血液透析的患者冻存外周血样本,共83例。根据超声诊断结果,将患者分为狭窄组(34例)和对照组(49例)。通过血常规计算NLR,检测外周血suPAR,并利用SPSS 27进行统计学分析,包括临床资料比较、多因素Logistic回归分析和ROC曲线分析。结果狭窄组患者的单核细胞计数和血清suPAR水平显著高于非狭窄组,且两者之间存在显著相关性。多因素Logistic回归分析显示,单核细胞和suPAR是动静脉内瘘狭窄的独立危险因素。ROC曲线分析表明,单核细胞和suPAR对动静脉内瘘狭窄具有较好的诊断效能。结论单核细胞和suPAR在动静脉内瘘狭窄的发病机制中可能发挥重要作用,为临床治疗提供了新的视角。Objective The purpose of this study is to explore the correlation between the neutrophil-to-lymphocyte ratio(NLR),monocytes,and soluble urokinase plasminogen activator receptor(suPAR)with the dysfunction of the arteriovenous fistula(AVF).Methods The study collected frozen peripheral blood samples from patients who underwent maintenance hemodialysis via autologous arteriovenous fistula at the First Affiliated Hospital of Army Medical University from September 30,2022,to September 30,2023.A total of 83 cases were included.Patients were divided into a stenosis group(34 cases)and a control group(49 cases)based on ultrasound diagnosis.NLR was calculated from routine blood tests,suPAR in peripheral blood was detected,and statistical analysis was performed using SPSS 27,including comparison of clinical data,multiple logistic regression analysis,and ROC curve analysis.Results The monocytes and serum suPAR levels in the stenosis group were significantly higher than those in the non-stenosis group,and there was a significant correlation between the two.Multiple logistic regression analysis showed that monocytes and suPAR are independent risk factors for AVF stenosis.ROC curve analysis indicated that monocytes and suPAR have good diagnostic efficacy for AVF stenosis.Conclusion Monocytes and suPAR may play an important role in the pathogenesis of AVF stenosis,providing a new perspective for clinical treatment.

关 键 词：维持性血液透析 动静脉内瘘狭窄 可溶性尿激酶型纤溶酶原激活物受体 单核细胞 

分 类 号：R459.5[医药卫生—治疗学]