摘要
目的探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与维持性血液透析(maintenance hemodialysis,MHD)患者全因死亡之间的关系。方法对九江市第一人民医院肾内科于2018年1月1日至2020年8月31日接受MHD治疗的患者进行观察,所有患者均随访至死亡、失访或截至日期(2023年8月31日)。根据NLR四分位数分为四组,采用Kaplan-Meier法比较各组患者的生存率,利用Cox回归分析NLR与全因死亡之间的相关性,并采用Logistic回归分析高NLR水平的影响因素。结果共443例患者纳入研究,平均生存时间21.51个月,NLR水平的中位数(四分位数间距)为3.84(2.55,5.79);Kaplan-Meier生存曲线显示NLR>5.79的患者全因死亡率较高(χ2=19.824,P<0.001)。多因素校正后四组间的全因死亡风险差异有统计学意义(P<0.05)。多因素Logistic回归结果显示高血清白蛋白是NLR>5.79的保护因素(P<0.05)。结论NLR>5.79是MHD患者全因死亡的独立危险因素,可作为评估MHD患者死亡风险的指标之一。
Objective To examine the association between neutrophil to lymphocyte ratio(NLR)and all-cause mortality in patients undergoing maintenance hemodialysis(MHD).Methods Patients who received MHD treatment in the Department of Nephrology,the first people’s Hospital of Jiujiang City from January 1,2018 to August 31,2020 were observed.All the patients were followed until they died,were lost to follow-up,or reached the cutoff date of August 31,2023.According to patients’NLR quartile value was divided into four groups,groups of patients were compared with the method of Kaplan-Meier analysis of survival rates,using Cox regression model analysis of the NLR and the correlation between for all-cause mortality,in patients with high levels of NLR is analyzed using Logistic regression analysis of influencing factors.Results A total of 443 patients were enrolled in this study.The average survival time was 21.51 months,and the median(interquartile range)of NLR was 3.84(2.55,5.79);Kaplan-Meier survival curve showed that all-cause mortality was higher in patients with NLR>5.79(χ2=19.824,P<0.001).The hazard ratios for all-cause death among the four groups remained statistically significant after multivariate adjustment(P<0.05).Multivariate Logistic regression analysis showed that high serum albumin was a protective factor for NLR>5.79(P<0.05).Conlusion NLR>5.79 is an independent risk factor for all-cause death in patients with MHD,and it can be used as one of the valuable indexes to evaluate the risk of death in patients with MHD.
作者
李洛华
张思雨
LI Luohua;ZHANG Siyu(Department of Nephrology,the First people’s Hospital of Jiujiang City,Jiujiang 332000,Jiangxi,China)
出处
《中国现代医生》
2024年第18期49-52,57,共5页
China Modern Doctor
