摘要
目的:评价中性粒细胞/淋巴细胞比值(NLR)、超敏C反应蛋白(hsCRP)与维持性血液透析(MHD)患者近期预后的相关性。方法:选择2018年7月于我院血液净化中心就诊且排除急性感染、恶性肿瘤、近期心脑血管事件及输血等病史的患者作为研究对象。收集患者入组时的一般临床资料和实验室数据,将其按照NLR≥3.5和hsCRP>3mg/L分别进行分组,分别随访1年后比较两组数据与MHD患者近期预后的相关性。结果:共纳入196例,其中男103例,女93例,平均年龄(56.54±12.77)岁,平均随访时间(11.41±2.06)个月。(1)随访期间研究对象发生心脑血管事件43例,死亡21例。(2)NLR、hsCRP阳性组患者心脑血管事件发生率及病死率均高于NLR、hsCRP阴性组患者,组间比较差异有统计学意义(P<0.05)。(3)单因素分析结果显示,MHD患者死亡与性别、年龄、医疗支付类型、心脑血管病史、hsCRP阳性及NLR阳性具有相关性;MHD患者发生心脑血管事件与性别、年龄、心脑血管病史、透析龄、hsCRP阳性和NLR阳性具有相关性。多因素分析结果显示,男性、心脑血管病史、hsCRP阳性和NLR阳性均是影响MHD患者预后的独立危险因素。(4)NLR、hsCRP阳性组患者的生存率均优于NLR、hsCRP阴性组患者(P<0.05)。(5)NLR联合hsCRP的ROC曲线下面积最大,与NLR、hsCRP比较,差异有统计学意义(P<0.05)。结论:血清NLR、hsCRP与MHD患者近期预后具有相关性。NLR联合hsCRP作为临床指标评估MHD患者近期预后的诊断效能优于NLR和hsCRP。
Objective:To evaluate the correlation of neutrophil/lymphocyte ratio(NLR),hypersensitive C-reactive protein(hsCRP)and short-term prognosis in patients with maintenance hemodialysis(MHD).Methods:MHD patients treated in hemodialysis center of our hospital in July 2018 were selected.Patients with severe infection,malignant carcinoma,recent cardiovascular and cerebrovascular events and blood transfusion were excluded.Demographic data and clinical parameters were collected.All people were divided separately according to NLR≥3.5 and hsCRP>3mg/L.During the 1-year follow-up,the correlation between the groups of data and the recent prognosis of MHD patients was compared.Results:196 MHD patients including 103 males and 93 females were selected with(56.54±12.77)average age and(11.41±2.06)months of mean follow-up time.(1)During the follow-up period,43 cases of the cardiovascular and cerebrovascular events occurred,and 21 cases died.(2)The incidence and mortality of the cardiovascular and cerebrovascular events in NLR and hsCRP positive groups were statistically significantly higher than those in NLR and hsCRP negative groups,separately(P<0.05).(3)Univariate analysis showed that death of MHD patients was correlated with gender,age,type of medical payment,history of cardiovascular and cerebrovascular disease,positive hsCRP and positive NLR.The incidence of cardiovascular and cerebrovascular events in MHD patients was correlated with gender,age,cardiovascular and cerebrovascular history,dialysis age,positive hsCRP and positive NLR.Multivariate analysis showed that male,history of cardiovascular and cerebrovascular disease,positive hsCRP and positive NLR were all independent risk factors affecting the prognosis of MHD patients.(4)The survival rate of NLR and hsCRP positive group were statistically higher separately than that of NLR and hsCRP negative group(P<0.05).(5)Compare with NLR and hsCRP,the area under ROC curve of NLR combined with hsCRP was statistically largest(P<0.05).Conclusion:NLR and hsCRP were correlated with t
作者
池小铿
陈晓婉
陈树鑫
陈桂贤
麦文霞
麦秋君
CHI Xiaokeng;CHEN Xiaowan;CHEN Shuxin(Department of Nephrology,Chaozhou People’s Hospital,Chaozhou City,Guangdong Province 521011)
出处
《医学理论与实践》
2021年第23期4054-4057,共4页
The Journal of Medical Theory and Practice
基金
2017年度潮州市科技计划基金资助项目(2017GY51)。
