机构地区:[1]中国人民解放军第三○五医院干部病房,北京100034 [2]南方医科大学第二临床医学院,广东广州510515
出 处:《中国循证心血管医学杂志》2025年第2期213-218,共6页Chinese Journal of Evidence-Based Cardiovascular Medicine
基 金:中国人民解放军第三○五医院重点项目(22YNZD05)。
摘 要:目的分析高血压前期(pre-hypertension,PHT)人群早期肾损害和白细胞及其相关衍生炎症指标之间的关系,为PHT早期肾损害患者提供新的诊疗思路。方法纳入2022年10月至2023年8月于中国人民解放军第三○五医院体检中心及干部病房就诊的1029例PHT患者。收集患者一般临床资料和实验室资料,检测血清胱抑素C(Cys-C)水平并计算中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)、单核细胞/淋巴细胞(MLR)、单核细胞/高密度脂蛋白(MHR)值。二元多因素Logistic回归分析探讨PHT早期肾损害的独立危险因素;计算受试者工作特征(ROC)曲线的曲线下面积(AUC)确定各指标分别及联合应用的诊断准确性。结果通过纳入及排除标准后共收集1029例PHT患者,其中PHT早期肾损害患者75例(7.29%),非肾损害患者954例(92.71%)。Pearson相关分析显示,白细胞计数(WBC)、NLR、MLR、MHR与Cys-C呈正相关(P<0.05),PLR与Cys-C相关性无统计学意义(P>0.05)。多因素Logistic回归分析发现,男性、高龄、体质指数(BMI)升高、尿酸升高、WBC升高、NLR升高、PLR升高、MLR升高是PHT早期肾损害的危险因素。基于上述结果,绘制ROC曲线分析发现,性别、年龄、BMI、WBC、NLR、MLR联合诊断的AUC值为0.794(95%CI:0.746~0.842),灵敏度为0.747,特异度为0.748,具有良好的诊断价值。结论WBC、NLR、PLR、MLR升高均是PHT早期肾损害的危险因素;性别、年龄、BMI、WBC、NLR、MLR联合检测对PHT早期肾损害具有良好的诊断价值。Objective To analyze the relationship among early renal impairment,leukocytes and their inflammation-derived indexes in patients with prehypertension(PHT),and provide new diagnostic and therapeutic insights for early renal impairment in PHT patients.Methods PHT patientsf(n=1029)were chosen from Geriatric Ward in Chinese PLA the 305th Hospital from Oct.2022 to Aug.2023.The general clinical materials and laboratory data were collected.The level of serum serum cystatin C(Cys-C)was detected,and value of neutrophilto-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR)and monocyte/high-density lipoprotein-cholesterol ratio(MHR)were calculated.The independent risk factors for PHT early renal impairment were analyzed by using binary multivariate Logistic regression analysis.The diagnostic accuracy of independent or combined indexes was determined after calculating AUC under ROC curve.Results After applying inclusion and exclusion criteria,a total of 1029 PHT patients were chosen,among them there were 75 patients(7.29%)with,and 954(92.71%)without early renal impairment.The results of Pearson correlation analysis showed that white blood cell count(WBC),NLR,MLR and MHR were positively correlated to Cys-C(P<0.05),and correlation between PLR and Cys-C had no statistical significance(P>0.05).The results of Logistic regression analysis showed that male,agedness,and increased body mass index(BMI),WBC,NLR,PLR and MLR were risk factors for PHT early renal impairment.The results of ROC curve analysis showed that,in diagnosis with combined gender,age,BMI,WBC,NLR and MLR,AUC was 0.794(95%CI:0.746~0.842),sensitivity was 0.747 and specificity was 0.748.Conclusion The increases of WBC,NLR,PLR and MLR are risk factors for PHT early renal impairment,and combined detection of gender,age,BMI,WBC,NLR and MLR has a higher diagnostic value to PHT early renal impairment.
分 类 号:R544.1[医药卫生—心血管疾病]
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