PLR、PTH及CRP与老年维持性血液透析患者全因及心血管事件死亡的关系

Relationship between PLR,PTH,CRP and all-cause and cardiovascular death in elderly patients with maintenance hemodialysis

目的探讨血小板/淋巴细胞比值(PLR)、甲状旁腺激素(PTH)及C反应蛋白(CRP)与老年维持性血液透析患者全因及心血管事件死亡的关系。方法选取2018年7月至2022年7月收治的老年维持性血液透析患者115例。收集患者一般资料并检测PLR、PTH及CRP水平。统计随访1年全因死亡率和心血管死亡率,并分析其危险因素。结果115例患者全因死亡率和心血管死亡率分别为14.78%和13.04%。Log-rank检验结果显示,PLR>300患者的全因死亡率和心血管死亡率均高于PLR≤300患者,差异有统计学意义(χ^(2)=5.274,4.001,P<0.05);且CRP>6 mg/L患者的全因死亡率和心血管死亡率均高于CRP≤6 mg/L患者,差异有统计学意义(χ^(2)=5.955,6.276,P<0.05)。单因素Cox回归分析结果显示,高水平的年龄、收缩压、血糖、PLR及CRP均与患者全因死亡(HR=2.835,3.111,2.389,3.912,3.274,P<0.05)和心血管死亡相关(HR=2.821,3.155,2.421,3.823,3.281,P<0.05)。多因素Cox分析显示,PLR及CRP水平升高患者全因死亡和心血管死亡风险仍显著升高,均为患者全因死亡(HR=2.500,3.582,P<0.05)和心血管事件死亡的独立危险因素(HR=2.627,3.629,P<0.05)。结论PLR及CRP水平均与老年维持性血液透析患者全因及心血管事件死亡关系显著,可能作为老年维持性血液透析患者全因及心血管事件死亡的早期评估参考指标。

Objective To explore the relationship between platelet/lymphocyte ratio(PLR),parathyroid hormone(PTH)and C-reactive protein(CRP)with all-cause and cardiovascular death in elderly patients with maintenance hemodialysis.Methods 115 elderly maintenance hemodialysis patients admitted from July 2018 toJuly 2022 were selected.The general data of patients were collected and the levels of PLR,PTH and CRP were detected.The all-cause mortality and cardiovascular mortality in 1 year followed up were counted,and their risk factors were analyzed.Results The all-cause mortality and cardiovascular mortality of 115 patients were 14.78%and 13.04%,respectively.Log-rank test results showed that the all-cause mortality and cardiovascular mortality of patients with PLR>300 were higher than those of patients with PLR≤300,and the difference were statistically significant(χ^(2)=5.274,4.001,P<0.05).And the all-cause mortality and cardiovascular mortality of patients with CRP>6 mg/L were higher than those of patients with CRP≤6 mg/L,and the difference were statistically significant(χ^(2)=5.955,6.276,P<0.05).The single-factor Cox regression analysis results showed that high levels of age,systolic blood pressure,blood glucose,PLR and CRP were all associated with all-cause death(HR=2.835,3.111,2.389,3.912,3.274,P<0.05)and cardiovascular death(HR=2.821,3.155,2.421,3.823,3.281,P<0.05).Multivariate Cox analysis showed that the risk of all-cause death and cardiovascular death in patients with elevated PLR and CRP levels was still significantly higher,both of which were independent risk factors for all-cause death(HR=2.500,3.582,P<0.05)and cardiovascular event death(HR=2.627,3.629,P<0.05).Conclusion The levels of PLR and CRP are significantly related to all-cause and cardiovascular death in elderly patients with maintenance hemodialysis and may be used as reference indicators for early assessment of all-cause and cardiovascular death in elderly patients with maintenance hemodialysis.