LYM、MHR与维持性血液透析患者腹主动脉钙化的相关性分析  

作　　者：杜霞 陆晓艳[1] 胡婷 黄加力 管春莺 

机构地区：[1]浙江中医药大学附属杭州市中医院,310007

出　　处：《浙江临床医学》2025年第3期404-406,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨维持性血液透析(MHD)患者淋巴细胞数(LYM)、单核细胞与高密度脂蛋白胆固醇比值(MHR)与腹主动脉钙化的相关性。方法回顾性分析2022年1月至2023年9月360例行MHD治疗患者的临床资料,根据腹部侧位平片腹主动脉钙化情况,分为无钙化组和钙化组,比较两组一般资料、LYM、MHR及其他实验室指标的差异,应用Logistic回归分析LYM、MHR对腹主动脉钙化的影响,采用ROC曲线评估LYM、MHR对腹主动脉钙化的预测价值。结果两组年龄、原发病、单核细胞数、LYM、MHR、白蛋白、前白蛋白、高敏C反应蛋白比较,差异有统计学意义(P<0.05)。Logistic回归分析显示,年龄、MHR、LYM为腹主动脉钙化的影响因素(P<0.05)。ROC曲线显示:年龄、LYM、MHR联合预测的曲线下面积(0.822)高于单一年龄(0.810)、LYM(0.603)、MHR(0.576)(P<0.05)。三者联合预测的截断值0.515,敏感度0.758,特异度0.757,约登指数0.515。结论MHD患者腹主动脉钙化现象较为普遍。淋巴细胞计数及MHR与腹主动脉钙化存在正相关。Objective To investigate the correlation between lymphocyte count(LYM),monocyte-to-high-density lipoprotein cholesterol ratio(MHR),and abdominal aortic calcification(AAC)in patients undergoing maintenance hemodialysis(MHD).Methods A total of 360 patients receiving MHD treatment from January 2022 to September 2023 were selected.Based on abdominal lateral radiographs,patients were divided into a non-calcification group and a calcification group.Differences in general characteristics,lymphocyte count,MHR,and other laboratory indicators were compared between the two groups.Logistic regression analysis was used to assess the impact of lymphocyte count and MHR on AAC,and the predictive value of lymphocyte count and MHR for AAC was evaluated using ROC curves.Results Significant differences were observed between the two groups in terms of age,primary disease,monocyte count,lymphocyte count,MHR,albumin,prealbumin,and high-sensitivity C-reactive protein(P<0.05).Logistic regression analysis revealed that age,MHR,and LYM were influencing factors for abdominal aortic calcification(P<0.05).ROC curve analysis revealed that the area under the curve(AUC)for the combination of age,lymphocyte count,and MHR(0.822)was higher than that for age alone(0.810),lymphocyte count alone(0.603),or MHR alone(0.576)(P<0.05).The optimal cutoff value for the combined prediction was 0.515,with a sensitivity of 0.758,specificity of 0.757,and Youden index of 0.515.Conclusion Abdominal aortic calcification is prevalent among MHD patients.Lymphocyte count and MHR are positively correlated with AAC.The combination of age,lymphocyte count,and MHR provides better predictive value for AAC than any single indicator alone.

关 键 词：维持性血液透析 淋巴细胞数 单核细胞/高密度脂蛋白胆固醇比值 腹主动脉钙化 

分 类 号：R692.5[医药卫生—泌尿科学]