中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (08): 624-628.doi: 10.3969/j.issn.1671-4091.2023.08.013

• 血管通路 • 上一篇    下一篇

不同血管通路对维持性血液透析患者中性粒细胞与淋巴细胞比值的影响

刘凤华    许 焱   

  1. 100028 北京，1应急管理部应急总医院肾内科
  • 收稿日期:2023-01-13 修回日期:2023-06-06 出版日期:2023-08-12 发布日期:2023-08-12
  • 通讯作者: 刘凤华 E-mail:tgzjgrml@sina.com

Effects of different vascular access on neutrophil to lymphocyte ratio in maintenance hemodialysis patients

LIU Feng-hua, XU Yan   

  1. Department of Nephrology, Emergency General Hospital, China Ministry of Emergency Management, Beijing 100028, China
  • Received:2023-01-13 Revised:2023-06-06 Online:2023-08-12 Published:2023-08-12
  • Contact: 100028 北京，1应急管理部应急总医院肾内科 E-mail:tgzjgrml@sina.com

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摘要： 目的  研究不同血管通路对维持性血液透析患者中性粒细胞与淋巴细胞比值及相关指标的影响。 方法  182例维持性血液透析(maintenance hemodialysis,MHD)患者，其中内瘘组130例，导管组52例，随访2年比较2组全血细胞、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio，NLR)、C反应蛋白(CRP)及部分生化指标的变化。 结果  随访开始2年后导管组与内瘘组相比，淋巴细胞(χ2=-2.338,P =0.019)、NLR(χ2=2.347,P =0.019)、CRP(χ2=2.688,P =0.007)间差异有统计学意义，多元线性回归分析结果显示NLR与白细胞(β=0.287,P＜0.001)、血小板计数(β=0.944,P＜0.001)呈正相关。随访前后导管组与内瘘组相比，血红蛋白(χ2=2.460,P=0.015)、白蛋白(χ2=4.101,P＜0.001)差异有统计学意义。 结论  以中心静脉隧道导管作为血管通路的维持性血液透析患者微炎症状态更重，NLR更高，贫血和营养不良更严重。

关键词: 维持性血液透析, 动静脉内瘘, 中心静脉导管, 炎症, 中性粒细胞与淋巴细胞比值

Abstract: Objective   To analyze the neutrophil to lymphocyte ratio (NLR) in maintenance hemodialysis (MHD) patients using the blood access method of central venous catheterization (CVC) or arterial venous fistula (AVF).  Methods   A   total of 182 MHD patients in our department were enrolled in this study. They were divided into CVC group (n=52) and AVF group (n=130). All of them received routine hemodialysis 3 times a week for at least three months. Changes of blood cells, NLR, serum biochemical indicators, and C-reactive protein (CRP) in the follow-up period of 2 years were compared.  Results   After the follow-up period of 2 years, lymphocyte (χ2=-2.338, P=0.019), NLR (χ2=2.347, P=0.019) and CRP (χ2=2.688, P=0.007) were higher in the CVC group than in the AFV group, and serum albumin and hemoglobin were lower in the CVC group than in the AFV group. Multivariate linear regression showed that NLR was positively correlated with white blood cells (β=0.287, P＜0.001) and platelet count (β=0.944, P＜0.001). Changes of hemoglobin (χ2=2.460, P=0.015) and albumin (χ2=4.101, P<0.001) during the follow-up period of 2 years were more in the CVC group than in the AVF group.  Conclusions   Patients using CVC as the blood access for MHD have higher degrees of microinflammation, NLR, anemia and malnutrition.

Key words: Maintenance hemodialysis, Arterial venous fistula, Central venous catheterization, Inflammation, Neutrophil to lymphocyte ratio

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