中性粒细胞与淋巴细胞比值对动静脉内瘘经皮腔内血管成形术后通畅率的影响

Effect of the neutrophil/lymphocyte ratio on patency rate of autologous arteriovenous fistulas after PTA

目的观察中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)对自体动静脉内瘘(autologous arteriovenous fistulas,AVF)狭窄经皮腔内血管成形术(percutaneous transluminal angioplasty,PTA)术后通畅率的影响。方法纳入2018年6月~2019年7月在安徽医科大学第二附属医院肾内科成功行PTA术患者84例,收集临床和随访资料。根据术前NLR水平分为高NLR组和低NLR组,对比2组基线资料,采用Log-rank检验分析2组间通畅率,使用COX多因素回归分析影响PTA术后通畅率的因素。结果男47例,女37例,平均随访时间(263.51±120.41)d。高NLR组较低NLR组术后再狭窄率高(χ^2=7.683,P=0.006),高NLR组血镁水平较低(t=2.486,P=0.015),高NLR组AVF通畅率低于低NLR组(Log Rank检验,χ^2=7.885,P=0.005)。结论高NLR是影响PTA术后AVF通畅率的独立危险因素。

Objective To investigate the effect of neutrophil/lymphocyte ratio(NLR)on patency of autologous arteriovenous fistulas(AVF)after percutaneous transluminal angioplasty(PTA).Methods This study consisted of 84 patients with successful PTA treated in the Department of Nephrology,the Second Hospital of Anhui Medical University between June 2018 and July 2019.Their clinical data and follow-up information were recruited.Patients were divided into two groups according to the level of NLR before PTA:high NLR group(n=42)and low NLR group(n=42).Survival analyses and log-rank test were used to compare the patency rate between the two groups.Multivariate Cox regression was used to analyze the interference factors for patency rate.Results There were 47 males and 37 females.The average follow-up time was 263.51±120.41 days.The rEstenosis rate was significantly higher in high NLR group compared to low NLR group(χ^2=7.683,P=0.006).Serum magnesium was lower in high NLR group(t=2.486,P=0.015).The patency of AVF was significantly lower in high NLR group than in low NLR group(log rank test:χ^2=7.885,P=0.005).Conclusion Higher NLR is an independent risk factor for the patency of AVF after PTA.