微炎症指标联合NLR检测对行维持性血液透析的终末期肾病患者预后的评估价值  

Prognostic Evaluation of Microinflammatory Markers Combined with NLR in Patients with End-Stage Renal Disease Undergoing Maintenance Hemodialysis

作　　者：方庆柏 田霞 FANG Qingbai;TIAN Xia(Department of Nephrology and Hemodialysis Center,Zhongwu Hospital,Suqian Jiangsu 223800)

机构地区：[1]江苏省宿迁市钟吾医院肾内科暨肾内科血液净化中心,江苏宿迁223800

出　　处：《医学临床研究》2025年第3期423-425,429,共4页Journal of Clinical Research

摘　　要：【目的】探讨微炎症指标联合中性粒细胞与淋巴细胞比值(NLR)对行维持性血液透析(MHD)的终末期肾病(ESRD)患者预后的评估价值。【方法】对行MHD的76例ESRD患者,随访1年,统计患者的预后情况,并据此分为预后不良组(A组,18例)和预后良好组(B组,58例),分析影响患者预后的相关因素及微炎症指标联合NLR检测对患者预后的评估效能。【结果】76例患者,预后不良发生率为23.68%(18/76)。A组营养不良占比、感染占比、透析龄、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及NLR均高于B组(P<0.05),A组残肾滤过率低于B组(P<0.05)。患者预后的独立影响因素包括残肾滤过率、hs-CRP及NLR(均P<0.05)。hs-CRP、NLR单一及联合预测行MHD的ESRD患者的灵敏度分别为72.22%、83.33%、66.67%,特异度为72.41%、65.52%、98.28%,联合诊断特异度高于单一诊断(P<0.05)。【结论】hs-CRP、NLR预测行MHD的ESRD患者预后的效能较好。【Objective】To explore the prognostic evaluation of microinflammatory markers combined with the neutrophil to lymphocyte ratio(NLR)in patients with end-stage renal disease(ESRD)undergoing maintenance hemodialysis(MHD).【Methods】A total of 76 ESRD patients undergoing MHD were followed up for one year,and their prognosis was recorded.Based on the outcomes,patients were divided into the poor prognosis group(Group A,18 cases)and the good prognosis group(Group B,58 cases).Factors influencing prognosis and the efficacy of microinflammatory markers combined with NLR in prognostic assessment were analyzed.【Results】Among the 76 patients,the incidence of poor prognosis was 23.68%(18/76).Group A had higher proportions of malnutrition and infection,longer dialysis duration,and significantly elevated levels of high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and NLR compared to Group B(P<0.05).Additionally,the residual renal filtration rate in Group A was significantly lower than that in Group B(P<0.05).Independent prognostic factors for ESRD patients included residual renal filtration rate,hs-CRP,and NLR(all P<0.05).The sensitivity of hs-CRP,NLR,and their combination in predicting the prognosis of ESRD patients undergoing MHD was 72.22%,83.33%,and 66.67%,respectively,while the specificity was 72.41%,65.52%,and 98.28%,respectively.The specificity of the combined diagnosis of both hs-CRP and NLR was significantly higher than that of single marker's diagnosis(P<0.05).【Conclusion】The hs-CRP and NLR have good predictive value for the prognosis of ESRD patients undergoing MHD.

关 键 词：肾病 肾透析 炎症趋化因子类 比值比 淋巴细胞 中性白细胞 预后 

分 类 号：R692[医药卫生—泌尿科学]