NLR与PLR在评价终末期肾病患者炎症中的作用

Role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in the evaluation of inflammation in patients with end stage renal disease

目的探讨中性粒细胞/淋巴细胞比值(NLR)及血小板/淋巴细胞比值(PLR)与终末期肾病患者炎症的关系。方法选取2016年1月至2017年6月在扬州市江都人民医院接受透析的100例终末期肾病患者,收集患者的一般临床资料及实验室指标。根据超敏C反应蛋白(hs-CRP)水平,将所有患者分为低危组(hs-CRP≤3 mg/L)和高危组(hs-CRP> 3 mg/L),并进行统计学分析。结果两组患者在性别组成、透析时间、ESRD病因、spKt/V及其他生化指标方面比较,无统计学差异(P> 0. 05)。高危组在年龄、甲状旁腺素、体质量指数、NLR、PLR方面均高于低危组,差异有统计学意义(P <0. 05)。Pearson相关性分析提示,NLR、PLR与hs-CRP呈正相关(r=0. 333,P <0. 05; r=0. 262,P <0. 05),与转铁蛋白饱和度(r=-0. 418,P <0. 05; r=-0. 309,P <0. 05)、血红蛋白(r=-0. 257,P <0. 05; r=-0. 124,P <0. 05)呈负相关。结论 NLR、PLR在评估终末期肾病维持性血液透析患者炎症方面具有潜在的临床价值。

Objective To evaluate the relationship between neutrophil-to-lymphocyte ratio（NLR）,platelet-to-lymphocyte ratio（PLR） and inflammation in end-stage renal disease（ESRD） patients. Methods 100 ESRD patients on maintenance HD were included in this study. Data on patient demographics,dry weight,body mass index,duration of HD（months）,etiology of ESRD,delivered dose of dialysis（spKt/V）,complete blood count,blood biochemistry and inflammatory markers including hs-CRP,NLR and PLR were recorded. According to the high sensitive C reactive protein（hs-CRP） levels,all patients were divided into two groups： low risk group（hs-CRP 3 mg/L,group A）,and high risk group（hs-CRP 3 mg/L,group B）.All data were statistically analyzed. Results The two groups were similar in terms of gender,etiology of ESRD and duration and dose of hemodialysis and other biochemical parameters（P〈0. 05）. The age,parathyroid hormone,body mass index,NLR,and PLR in group A were significantly lower than group B（P〈0. 05）. Pearson correlation analysis showed that NLR and PLR were positively correlated with hs-CRP（r = 0. 333,P〈0. 05; r = 0. 262,P〈0. 05）,and negatively with the saturation of transferring（r =-0. 418,P〈0. 05; r =-0. 309,P〈0. 05） and hemoglobin（r =-0. 257,P〈0. 05; r =-0. 124,P〈0. 05）. Conclusions NLR and PLR have potential clinical values in evaluating the inflammation of ESRD patients undergoing maintenance HD.