中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (08): 482-485.doi: 10.3969/j.issn.1671-4091.2015.08.010

• 临床研究 • 上一篇    下一篇

中性粒细胞淋巴细胞比值在评价慢性肾脏病患者炎症状态中的作用

张国娟,黄雯 陈燊   

  1. 首都医科大学附属北京同仁医院肾内科
  • 收稿日期:2015-04-20 修回日期:2015-05-14 出版日期:2015-08-12 发布日期:2015-08-12
  • 通讯作者: 陈燊 cs99@163.com E-mail:huangw6@126.com

The value of neutrophil and lymphocyte ratio in the evaluation of inflammation status in patients with chronic kidney disease

  • Received:2015-04-20 Revised:2015-05-14 Online:2015-08-12 Published:2015-08-12

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摘要： 【摘要】目的明确慢性肾脏病(CKD)患者中性粒细胞淋巴细胞比值(NLR)与炎症的关系，为临床监测CKD 患者的炎症状态提供一个简便的途径。方法以64 名透析前CKD3-5 期患者及72 名稳定的维持性血液透析(HD)患者为观察对象，以22 名健康体检者为对照组，检测血常规及血生化，应用SPSS17.0 软件进行统计学分析。采用单因素方差分析比较各组血液学指标之间的差异。根据NLR 中位数将透析前CKD患者及HD 患者分别分为2 组，采取独立样本t 检验分析2 组患者之间高敏C 反应蛋白(hsCRP)、血浆白蛋白(ALB)等指标之间的差异，采用spearman 相关来分析NLR 与其它变量之间相关的关系。结果透析前CKD 患者淋巴细胞绝对值、NLR 及hsCRP 分别为1.76±0.61×109/L，2.78±1.75 及4.95±5.31 mg/L，HD 患者淋巴细胞绝对值、NLR 及hsCRP 分别为1.53±0.48×109/L，3.73±1.75 及12.02±9.84mg/L，均显著高于正常对照组患者相应指标(P＜0.05)，其中HD 患者上述三值显著高于透析前CKD 患者(P＜0.05)；透析前CKD 患者ALB 为29.91± 6.83 g/L,HD 患者ALB 为35.39±5.61g/L，均显著低于正常对照组(P＜0.05)。透析前CKD 患者NLR≥2.25 与NLR＜2.25 组者相比，各项指标无统计学差异；HD 患者NLR≥3.5 组ALB、TG 分别为33.65±4.69g/L，1.43±0.53mmol/L，显著低于NLR＜3.5 组(P＜0.05)，hsCRP 为19.81±14.80mg/L，显著高于NLR＜3.5 组(P＜0.05)。HD 患者NLR 与ALB 呈负相关(r=-0.294，P =0.014)，与hsCRP 呈正相关(r=0.317，P =0.008)，而透析前CKD 患者NLR 与ALB 及hsCRP 均无相关性。结论在HD 患者中，NLR 可以作为一个反映系统炎症的指标。

关键词: 慢性肾脏病, 血液透析, 中性粒细胞淋巴细胞比值, 炎症

Abstract: 【Abstract】Objective To investigate the relationship between neutrophil / lymphocyte ratio (NLR) and inflammation in patients with chronic kidney disease (CKD) in order to provide a simple method to evaluate inflammation status in CKD patients. Methods Sixty-four CKD patients (at stage 3-5) before dialysis and
72 CKD patients on maintenance hemodialysis (MHD) with stable clinical conditions treated in Bejing Tongren Hospital were recruited for this study. Twenty-two healthy individuals were used as the controls. Statistical differences of laboratory parameters among the 3 groups were compared using one-way ANOVA. The predialysis CKD patients and MHD patients were further divided into 2 groups according to the median value of NLR. hsCRP, ALB and other laboratory parameters were compared between the 2 groups using Student’s ttest. The relationship between NLR and other parameters was assessed using Spearman correlation. Results Lymphocyte count, NLR and hsCRP were 1.76±0.61×109/L, 2.78±1.75 and 4.95±5.31 mg/L, respectively, in predialysis patients, and were 1.53±0.48×109/L, 3.73±1.75 and 12.02±9.84 mg/L, respectively, in MHD patients; the three values were significantly higher in pre- dialysis patients and MHD patients than in controls, and the values of NLR and hsCRP were significantly higher in MHD patients than in pre-dialysis patients (P＜ 0.05). ALB was 29.91± 6.83 g/L in pre-dialysis patients, and was 35.39±5.61g/L in MHD patients, significantly lower in pre-dialysis patients and MHD patients than in controls (P＜0.05). In predialysis patients, laboratory parameters had no differences between patients with NLR ≥2.25 and those with NLR ＜2.25. In MHD patients, ALB and triglyceride were 33.65 ± 4.69 g/L and 1.43 ± 0.53 mmol/L, respectively, in patients with NLR ≥3.5, significantly lower than those in patients with NLR ＜3.5 (P＜0.05); hsCRP was 19.81±14.80 mg/L in patients with NLR≥3.5, significantly higher than that in patients with NLR＜3.5 (P＜0.05). NLR was negatively correlated with ALB (r=-0.294, P=0.014) and positively correlated with hsCRP (r=0.317, P =0.008) in MHD patients but not in pre-dialysis patients. Conclusion NLR may be used as a marker of systemic inflammation in MHD patients.

Key words: chronic kidney disease, hemodialysis, neutrophil lymphocyte ratio, inflammation