中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (07): 446-449.doi: 10.3969/j.issn.1671-4091.2018.07.004

• 临床研究 • 上一篇    下一篇

中性粒细胞与淋巴细胞比值在腹膜透析相关性感染中的临床意义

詹秋楠1,陈晓莉1,李丹丹1,王瑞峰1,郝丽1,刘桂凌1   

  1. 1.安徽医科大学第二附属医院肾内科
  • 收稿日期:2017-11-20 修回日期:2018-04-18 出版日期:2018-07-12 发布日期:2018-07-12
  • 通讯作者: 刘桂凌 guilingliu369@163.com E-mail:guilingliu369@163.com

The clinical significance of neutrophil- to- lymphocyte ratio in peritoneal dialysis related infection

  • Received:2017-11-20 Revised:2018-04-18 Online:2018-07-12 Published:2018-07-12

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摘要： 【摘要】目的观察中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)在腹膜透析相关性感染发生中的临床意义。方法选取2012 年1 月～2016 年12 月在安徽医科大学第二附属医院因腹膜透析相关性感染住院的患者，与同期入院的腹膜透析非感染的患者相比较。纳入指标包括年龄、性别、有无糖尿病病史、血红蛋白、血清白蛋白、血钾、血镁、血钙(校正血钙)、血磷、三酰甘油、总胆固醇、超敏C 反应蛋白及NLR，分析上述指标与腹膜透析相关性感染的关系。结果共纳入研究对象211例，两组患者年龄(52.66±14.53 比52.35±15.07，t=0.150，P=0.881)、性别(男性数54 比51，χ2=2.099，P=0.147)、有无糖尿病病史(有糖尿病12 比12，χ2=0.451，P=0.502)、血红蛋白(91.05±20.04 比93.77±18.25g/L，t=-1.017，P=0.311)、血钾(3.59±0.75 比3.77±0.72mmol/，t=-1.696，P=0.091)、三酰甘油[1.21(0.82，1.58) 比1.19(0.81,1.66)mmol/L，Z=- 0.179，P=0.919] 及总胆固醇[(4.44 ± 1.09) 比(4.67±1.06)mmol/L，t=0.158，P=0.784]无统计学差异；感染组NLR[6.29(3.85,10.35)比2.71(2.70,3.78)，Z=-8.321，P=0.000]、血钙[2.43(2.28,2.61)比2.34(2.18,2.44)mmol/L，Z=-3.164，P=0.002]及超敏C 反应蛋白[(66.67±64.53)比(6.57±10.86)mg/L，t=8.833，P=0.000]高于对照组，而血清白蛋白[(26.38±6.79)比(29.59±5.30)g/L，t=-3.742，P=0.000]、血镁[(0.72± 0.17)比(0.79±0.16)mmol/L，t=-3.167，P=0.002]、血磷[1.26(0.98,1.50)比1.31(1.13,1.64)mmol/L，Z=-2.040，P=0.041]低于对照组。Spearman 多因素相关分析提示腹膜透析相关性感染与NLR(r=0.574，P=0.000)、血钙(r=0.218，P=0.001)及超敏C 反应蛋白(r=0.188，P=0.006)呈正相关；而与血清白蛋白(r=- 0.224，P=0.001)、血镁(r= -0.224，P=0.001)、血磷(r=-0.141，P=0.041)呈负相关。Logistic 回归分析提示NLR 及血清白蛋白与腹膜透析相关性感染有密切关系，高水平的NLR 和较低的血清白蛋白是其危险因素。结论腹膜透析相关性感染患者的中性粒细胞与淋巴细胞比值、血钙及超敏C 反应蛋白水平普遍偏高，而血清白蛋白、
血镁、血磷较低。较高的NLR和较低的血清白蛋白是其危险因素。

关键词: 中性粒细胞与淋巴细胞比值, 腹膜透析, 感染

Abstract: 【Abstract】Purpose To observe the clinical significance of neutrophil- to- lymphocyte ratio (NLR) in peritoneal dialysis (PD) related infection. Methods A total of 119 hospitalized patients with PD-related infection treated in the Second Hospital of Anhui Medical University between Jan. 2012 and Dec. 2016 were compared with the 92 hospitalized PD patients without infection during the same period. Age, gender, diabetes history, hemoglobin, serum albumin, serum potassium, serum magnesium, corrected serum calcium, serum phosphorus, triglycerides, total cholesterol, hs-CRP and NLR were collected and compared between the two groups of patients. Results A total of 211 cases were recruited in this study. There were no statistical differences in age (52.66±14.53 vs. 52.35±15.07 years, t=0.150, P=0.881), gender (54 males vs. 51 females, χ2=2.099, P=0.147), diabetes history (12 vs. 12, χ2=0.451, P=0.502), hemoglobin level (91.05±20.04 vs. 93.77±18.25 g/L, t=-1.017, P=0.311), serum potassium (3.59±0.75 vs. 3.77±0.72 mmol/L, t=-1.696, P=0.091), triglycerides [1.21 (0.82, 1.58) vs. 1.19 (0.81, 1.66) mmol/L, Z=-0.179, P=0.919] and total cholesterol (4.44±1.09 vs. 4.67±1.06 mmol/L, t=0.158, P=0.784) between the two groups. Compared to the non-infection group, NLR [6.29 (3.85, 10.35) vs. 2.71 (2.70, 3.78), Z=- 8.321, P＜0.001], corrected serum calcium [2.43 (2.28, 2.61) vs. 2.34(2.18,2.44) mmol/L, Z=-3.164, P=0.002] and hs-CRP (66.67±64.53 vs. 6.57±10.86 mg/L, t=8.833, P＜0.001) were significantly higher in the infection group, while serum albumin (26.38 ± 6.79 vs. 29.59±5.30 g/L, t=-3.742, P＜0.001), serum magnesium [(0.72±0.17) vs. (0.79±0.16) mmol/L, t=-3.167, P=0.002] and serum phosphorus [1.26 (0.98, 1.50) vs. 1.31 (1.13, 1.64) mmol/L, Z=-2.040, P=0.041] were significantly lower in the infection group. Spearman multivariate correlation analysis indicated that PD-related infection was positively correlated to NLR (r=0.574, P=0.000), corrected serum calcium (r=0.218, P=0.001) and hs-CRP (r=0.188, P=0.006), and negatively correlated to serum albumin (r=-0.224, P=0.001), serum magnesium (r=-0.224, P=0.001) and serum phosphorus (r=-0.141, P=0.041). Logistic regression analysis suggested that higher NLR and lower serum albumin were closely associated with PD-related infection. Conclusion NLR, corrected serum calcium and hs-CRP were elevated, while serum albumin, serum magnesium and serum phosphorus were lower in PD-related infection patients. Higher NLR and lower serum albumin were the risk factors for PD-related infection.

Key words: neutrophil-to-lymphocyte ratio, peritoneal dialysis, infection