中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (07): 473-476.doi: 10.3969/j.issn.1671-4091.2019.07.003

• 临床研究 • 上一篇    下一篇

血小板/淋巴细胞比值与持续非卧床腹膜透析患者炎症状态的关系

陈天雷1,杨敏1   

  1. 1. 苏州大学附属第三医院常州市第一人民医院肾脏科
  • 收稿日期:2018-12-03 修回日期:2019-05-01 出版日期:2019-07-12 发布日期:2019-07-12
  • 通讯作者: 杨敏 yangmin79@sina.com

The relationship between platelet/lymphocyte ratio and inflammation status in patients on continuous ambulatory peritoneal dialysis#br#

  1. The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China
  • Received:2018-12-03 Revised:2019-05-01 Online:2019-07-12 Published:2019-07-12

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摘要： 【摘要】目的研究持续非卧床腹膜透析(continuous ambulatory peritoneal dialysis, CAPD)患者血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)与炎症状态的关系，为临床评估CAPD 患者的炎症状态提供简便、可靠的指标。方法以70 名CAPD 患者为研究对象，以35 名健康体检患者为对照。检测所有研究对象的血常规、血生化指标及超敏C 反应蛋白(high sensitive C-reactive protein,
hs-CRP)，计算PLR、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)，比较2 组上述指标的差异。同时，根据PLR 平均值将CAPD 患者分为2 个亚组，比较2 亚组上述指标间的差异。采用Spearman 相关分析PLR 与NLR、白蛋白、hs-CRP 等的相关关系。结果与健康对照组相比，CAPD 患者中性粒细胞数、尿素氮、血肌酐、三酰甘油、PLR、NLR 及hs- CRP 明显升高(t 值分别为- 3.709，- 19.858，- 27.883，- 5.929，- 4.320，- 10.224，- 9.478；P 值分别为＜0.001，＜0.001，＜0.001，＜0.001，＜0.001，＜0.001，＜0.001)。而CAPD 患者的淋巴细胞数、血小板、血红蛋白、白蛋白和高密度脂蛋白则明显低于健康对照组(t 值分别为9.369，5.263，15.108，11.231，7.164；P 值分别为＜0.001，＜0.001，＜0.001，＜0.001，＜0.001)。CAPD 患者的PLR 平均值为136，PLR≥136 组的白细胞、淋巴细胞数明显少于PLR＜136 组(t 值分别为2.155，4.434；P 值分别为0.035，＜0.001)。但是，血小板、NLR 及hs-CRP 则显著高于PLR＜136 组(t 值分别为-4.408，-2.707，-2.948；P 值分别为＜0.001，0.009，0.005)；同时，CAPD患者PLR 与血红蛋白、淋巴细胞、白蛋白呈负相关(r 值分别为- 0.307，- 0.588，- 0.246；P 值分别为0.001，＜0.001，0.012)，与血小板、尿素氮、血肌酐、hs-CRP、NLR 呈正相关(r 值分别为0.281，0.278，0.196，0.354，0.460；P 值分别为0.004，0.004，0.045，＜0.001，＜0.001)。结论PLR 可作为一个反映CAPD 患者炎症状态的简便、可靠的新指标。

关键词: 腹膜透析, 血小板/淋巴细胞比值, 中性粒细胞/淋巴细胞比值, 炎症

Abstract: 【Abstract】Objective To investigate the relationship between platelet/lymphocyte ratio (PLR) and inflammation status in patients on continuous ambulatory peritoneal dialysis (CAPD) in order to explore a new biomarker for the inflammation status of CAPD patients. Methods A total of 70 CAPD patients treated in the First People's Hospital of Changzhou and 35 healthy individuals as the controls were enrolled in this study. PLR and other laboratory parameters were compared between CAPD patients and controls. CAPD patients were further divided into two subgroups according to the mean value of PLR. Neutrophil/lymphocyte ratio (NLR), high sensitive C- reactive protein (hs- CRP) and other parameters were compared between the two CAPD patient subgroups. The relationship between PLR and NLR, albumin and hs-CRP was assessed using Spearman correlation. Results Neutrophil (t=-3.709, P＜0.001), urea nitrogen (t=-19.858, P＜0.001), creatinine (t=-27.883, P＜0.001), triacylglycerol (t=-5.929, P＜0.001), PLR (t=-4.320, P＜0.001), NLR (t=-10.224, P＜0.001) and hs-CRP (t=- 9.478, P＜0.001) were significantly higher in CAPD patients than in controls. Lymphocyte (t=9.369, P＜0.001), platelet (t=5.263, P＜0.001), hemoglobin (t=15.108, P＜0.001), albumin (t=11.231, P＜0.001) and high density lipoprotein cholesterol (t=7.164, P＜0.001) were significantly lower in CAPD patients than in controls. The mean value of PLR was 136 in CAPD patients. Neutrophil (t=2.155, P=0.035) and lymphocyte (t=4.434, P＜0.001) count were significantly lower in CAPD patients with PLR ≥136 than in those with PLR＜136. Platelet count (t=-4.408, P＜0.001), NLR (t=-2.707, P=0.009) and hs-CRP (t=-2.948, P=0.005) were significantly higher in the CAPD patients with PLR ≥136 than in those with PLR＜136 (P<0.05). PLR was negatively correlated with hemoglobin (r=- 0.307, P=0.001), lymphocyte count (r=-0.588, P＜0.001) and albumin (r=-0.246, P＜0.012), and positively correlated with platelet count (r=0.281,P=0.004), urea nitrogen (r=0.278, P=0.004), creatinine (r=0.196, P= 0.045), hs-CRP (r=0.354, P＜0.001) and NLR (r=0.460, P＜0.001) in CAPD patients. Conclusion PLR can be used as a new biomarker of inflammation status in CAPD patients.

Key words: Continuous ambulatory peritoneal dialysis, Platelet to lymphocyte ratio, Neutrophil to lymphocyte ratio, Inflammation

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