中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (03): 157-160.doi: 10.3969/j.issn.1671-4091.2021.03.003

• 临床研究 • 上一篇    下一篇

中性粒细胞淋巴细胞比值、营养状态与血液透析患者腹主动脉钙化的相关性分析

甘言刚1,赵明明2,冯锦红1   

  1. 徐州医科大学附属医院1肾内科；2放射科
  • 收稿日期:2020-10-15 修回日期:2020-11-04 出版日期:2021-03-12 发布日期:2021-03-12
  • 通讯作者: 冯锦红 feng_jh@189.cn E-mail:feng_jh@189.cn

Analysis of the relationship between neutrophils-to-lymphocytes ratio, nutritional status and abdominal aortic calcification in hemodialysis patients 

  1. 1Department of Nephrology, 2Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou
    221000, China
  • Received:2020-10-15 Revised:2020-11-04 Online:2021-03-12 Published:2021-03-12

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摘要： 【摘要】目的探讨维持性血液透析(maintenance hemodialysis，MHD)患者中性粒细胞淋巴细胞比值(neutrophils-to-lymphocytes ratio，NLR)、营养状态与腹主动脉钙化(abdominal aortic calcification，AAC)的关系，同时分析影响AAC 的危险因素。方法选取2019 至2020 年在徐州医科大学附属医院血液净化中心治疗的MHD 患者。收集患者的一般临床资料及实验室检查结果，用腹部侧位X 线平片检查患者AAC 的情况。老年营养风险指数(geriatric nutritional risk index，GNRI)评估患者营养状况。根据是否发生腹主动脉钙化将患者分为非钙化组和钙化组。比较两组间各指标的差异，采用二元Logistic 回归分析法探讨AAC 发生的危险因素。结果共纳入72 例MHD 患者，钙化组37 例，非钙化组35 例。与非钙化组相比，钙化组年龄、糖尿病患病率、甲状旁腺激素（parathyroid hormone, PTH）、C 反应蛋白（C-creative protein, CRP）、NLR 均明显升高（t/Z/χ2值分别为3.194, 4.766, 2.698, 2.587, 2.943；P值分别为0.002, 0.029, 0.007, 0.010, 0.004），白蛋白（Z=﹣2.947，P=0.003）、GNRI（χ2=﹣2.475，P=0.016）明显降低。Spearman 相关性分析显示AAC 与年龄、PTH、NLR、CRP 呈正相关（r 值分别为0.343，0.320，0.307，0.293；P 值分别为0.003, 0.006, 0.009, 0.010），与白蛋白（r=-0.350，P=0.003）、GNRI（r=-0.263，P=0.026）呈负相关。Logistic 回归分析发现：年龄（OR=1.077，95% CI:1.017～1.141, P=0.012）、糖尿病（OR=4.545, 95% CI：1.032～20.007, P=0.045）、NLR（OR=2.463, 95%CI：1.317～4.608, P=0.005）为AAC 的危险因素，白蛋白水平升高则为AAC 的保护性因素（OR=0.870，95%CI：0.771～0.982，P=0.024）。结论 NLR 及营养不良与MHD 患者AAC 相关。年龄、糖尿病、白蛋白水平及NLR是AAC 的独立危险因素。

关键词: 维持性血液透析, 中性粒细胞淋巴细胞比值, 营养, 腹主动脉钙化

Abstract: 【Abstract】Objective To investigate the relationship between neutrophils-lymphocytes ratio (NLR), nutritional status and abdominal aortic calcification (AAC) in maintenance hemodialysis (MHD) patients, and to analyze the risk factors of AAC. Methods MHD patients treated in the Blood Purification Center of the Affiliated Hospital of Xuzhou Medical University from 2019 to 2020 were selected. The clinical data and laboratory examination results of patients were collected, and the AAC of patients was examined by abdominal lateral X-ray film. The geriatric nutritional risk index (GNRI) was used to evaluate patients’nutritional status. According to whether abdominal aortic calcification occured, the patients were divided into non- calcification group and calcification group. The differences of indices between the two groups were compared, and binary Logistic regression analysis was used to explore the risk factors of AAC. Results A total of 72 patients with MHD were included, divided into calcification group (n= 37) and non-calcification group (n=35). Compared with the non-calcified group, patients in calcification group were older, with higher proportion of diabetes mellitus, and with higher parathyroid hormone (PTH), C-creative protein (CRP) and NLR, lower albumin, GNRI (P＜0.05). Correlation analysis showed that AAC was positively correlated with age, PTH, CRP and NLR, but negatively correlated with Alb and GNRI (P＜0.05). Logistic regression analysis showed that age, diabetes mellitus, lower albumin and higher NLR were independent risk factors for abdominal aortic calcification.Conclusions NLR and malnutrition status are associated with AAC in patients with MHD. Old age, diabetes mellitus, lower albumin and higher NLR are independent risk factors for abdominal aortic calcification.

Key words: maintenance hemodialysis, neutrophils-to-lymphocytes ratio, Geriatric nutritional risk index, Abdominal aortic calcification

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