发热性下尿路感染患者血清NLR、NGAL、LymC水平与急性肾盂肾炎发生的关系

The expression of serum NLR, NGAL and LymC levels in patients with febrile lower urinary tract infection and their relationship with the occurrence of acute pyelonephritis

目的探讨发热性下尿路感染(FLUTI)患者的中性粒细胞/淋巴细胞比值(NLR)、血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、淋巴细胞计数(LymC)水平与急性肾盂肾炎(APN)发生的关系。方法回顾性分析2017年10月至2021年10月在联勤保障部队第九〇九医院肾脏内科收治的206例FLUTI患者,根据是否发生APN将患者分为合并APN组(92例)和不合并APN组(114例)。检测两组的白细胞计数(WBC)、血沉(ESR)、C反应蛋白(CRP)、LymC、NLR和NGAL水平并进行受试者工作特征(ROC)曲线分析。结果合并APN组的WBC、ESR、CRP、NLR、NGAL显著高于不合并APN组(均P<0.05),而LymC低于不合并APN组(P<0.05)。NLR与WBC、ESR、CRP指标呈正相关,NGAL与ESR、CRP指标呈正相关,LymC与WBC、ESR、CRP指标呈负相关(均P<0.05)。ESR、CRP、NLR、NGAL、LymC是影响FLUTI发生APN的独立危险因素(均P<0.05)。NLR、NGAL、LymC预测FLUTI患者APN发生的曲线下面积(AUC)分别为0.846(95%CI:0.788~0.865)、0.812(95%CI:0.773~0.856)、0.796(95%CI:0.738~0.834),其灵敏度和特异度分别为79.4%、82.4%、77.3%,84.6%、78.6%、80.6%。结论LymC、NLR和NGAL可作为FLUTI患者是否发生APN的炎性标志物。

Objective To investigate the neutrophil/lymphocyte ratio(NLR),serum neutrophil gelatinase-associated lipocalin(NGAL)and lymphocyte count(LymC)levels in patients with febrile lower urinary tract infection(FLUTI)and their relationship with acute pyelonephritis(APN).Methods A total of 206 patients with FLUTI admitted to the 909th Hospital of Joint Logistics Support Forcce from October 2017 to October 2021 were retrospectively analyzed.According to the presence or absence of APN,the patients were divided into APN group(92 cases)and non-APN group(114 cases).The white blood cell count(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),LymC,NLR and NGAL of the two groups were detected and analyzed by ROC curve.Results The WBC,ESR,CRP,NLR and NGAL in the APN group were significantly higher than those in the non-APN group(all P<0.05),while LymC was lower than that in the non-APN group(P<0.05).NLR was positively correlated with WBC,ESR and CRP indexes,NGAL was positively correlated with ESR and CRP indexes,LymC was negatively correlated with WBC,ESR and CRP indexes(all P<0.05).ESR,CRP,NLR,NGAL and LymC were independent risk factors for APN in FLUTI patients(all P<0.055).The area under the curve(AUC)of NLR,NGAL and LymC for predicting APN in patients with FLUTI was 0.846(95%CI:0.788-0.865),0.812(95%CI:0.773-0.856)and 0.796(95%CI:0.738-0.834),respectively.The sensitivity and specificity were 79.4%,82.4%,77.3%and 84.6%,78.6%,80.6%,respectively.Conclusions LymC,NLR,and NGAL can be used as inflammatory markers for the occurrence of APN in patients with FLUTI.