维持性血液透析患者外周血NLR、PLR、LMR不同细胞比值与超敏C反应蛋白的相关性

Correlation between NLR,PLR and LMR cell ratios in peripheral blood and high-sensitivity C-reactive protein in maintenance hemodialysis patients

目的:研究维持性血液透析(MHD)患者中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)以及淋巴细胞/单核细胞比值(LMR)与超敏C反应蛋白(hs-CRP)的相关性。方法:选取2017年1月至2018年7月广西医科大学第一附属医院收治的180例MHD患者(MHD组),根据hs-CRP水平将其再分为hs-CRP低水平(<3.0 mg/L)组和hs-CRP高水平(≥3.0 mg/L)组。同期选取40例健康体检者作为对照组。检测NLR、PLR和LMR。采用Pearson相关分析法分析MHD患者NLR、PLR、LMR与hs-CRP的相关性,受试者工作特征(ROC)曲线评估NLR、PLR和LMR预测MHD患者微炎症状态的灵敏度和特异度。结果:MHD组NLR、PLR和hs-CRP水平显著高于对照组,LMR低于对照组(均P<0.05)。hs-CRP高水平组NLR和PLR高于hs-CRP低水平组,LMR低于hs-CRP低水平组(均P<0.05)。MHD患者NLR、PLR与hs-CRP呈正相关关系(r=0.339、0.241,均P<0.01),LMR与hs-CRP呈负相关关系(r=-0.207,P<0.01)。NLR的ROC曲线下面积(AUC)为0.681,PLR的AUC为0.626,LMR的AUC为0.188,LMR倒数(1/LMR,MLR)的AUC为0.812(均P<0.05);MLR的敏感性(58.6%)和特异性(87.3%)高于NLR(43.6%、73.5%)和PLR(37.1%、64.9%)。结论:外周血NLR、PLR及LMR与MHD患者hs-CRP水平相关,对评估MHD患者微炎症状态有一定的临床价值。

Objective:To analyze the correlation between the neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR)and hypersensitive C-reactive protein(hs-CRP)in maintenance hemodialysis(MHD)patients.Methods:From January 2017 to July 2018,180 MHD patients(MHD group)in our hospital were enrolled,and subdivided into two groups according to the level of hs-CRP:low hs-CRP group(<3.0 mg/L)and high hs-CRP(≥3.0 mg/L)group.A total of 40 healthy subjects were selected as a control group.The values of NLR,PLR and LMR were calculated.The correlation between the NLR,PLR,LMR and hs-CRP level in MHD patients was analyzed by Pearson correlation analysis,and the sensitivity and specificity of NLR,PLR and LMR in the microinflammatory state of MHD patients were evaluated by receiver operating characteristic(ROC)curve.Results:The NLR,PLR and hs-CRP level in the MHD group were higher than those in the control group,while the LMR was significantly lower(P<0.05).The NLR and PLR in high hs-CRP group were higher than those in low hs-CRP group,while the LMR level was lower(P<0.05).The NLR and PLR were positively correlated with hs-CRP level(r=0.339 and 0.241,P<0.01).The area under ROC curve(AUC)of NLR was 0.681,AUC of PLR was 0.626,AUC of LMR was 0.188,AUC of 1/LMR was 0.812(P<0.05).The sensitivity and specificity of MLR(58.6%)and specificity(87.3%)were higher than those of NLR(43.6%,73.5%)and PLR(37.1%,64.9%).Conclusion:NLR,PLR and LMR were associated with hs-CRP level in MHD patients.