维持性腹膜透析患者外周血NLR PLR HGB水平变化及其与钙磷代谢异常和全因病死率的关系

doi:10.3969/j.issn.1006-6233.2024.01.018

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摘要 目的: 探究维持性腹膜透析患者外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、血红蛋白(HGB)水平变化及其与钙磷代谢异常和全因病死率的关系。方法: 选取2019年3月至2022年6月收治的维持性腹膜透析患者206例,评估患者是否存在钙磷代谢异常,分为异常组和正常组,比较两组外周血NLR、PLR、HGB水平,分析NLR、PLR、HGB与血钙、血磷水平相关性;随访至2022年12月,以全因病死为终点事件,分为病死组和存活组,比较两组外周血NLR、PLR、HGB水平,并用受试者工作特征(ROC)曲线评价NLR、PLR、HGB对患者全因病死的预测价值。结果: 异常组外周血NLR、PLR及血磷水平高于正常组,血钙水平低于正常组(P<0.05);但两组年龄、性别、文化程度、原发疾病、透析时间及外周血HGB水平的比较,差异无统计学意义(P>0.05)。维持性血液透析老年患者外周血NLR、PLR与血钙水平呈负相关,与血磷水平呈正相关(P<0.05);而HGB与血钙、血磷水平无明显相关性(P>0.05)。病死组透析时间长于存活组,外周血NLR、PLR及血磷水平高于存活组,血钙水平低于存活组(P<0.05);但两组年龄、性别、文化程度、原发疾病及外周血HGB水平的比较,差异无统计学意义(P>0.05)。ROC曲线分析结果显示,外周血NLR、PLR预测患者全因病死的曲线下面积(AUC)分别为0.777(95%CI:0.688~0.866)、0.781(95%CI:0.668~0.895)。结论: 维持性腹膜透析患者钙磷代谢异常与外周血NLR、PLR水平相关,且上述指标对患者全因病死具有一定的预测价值。

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	梅吉本
	何静
	陈忠辉
	束长东

关键词 ：维持性腹膜透析, 中性粒细胞与淋巴细胞比值, 血小板与淋巴细胞比值, 血红蛋白, 钙磷代谢, 全因病死

Abstract：Objective: To explore the changes in peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hemoglobin (HGB) levels in maintenance peritoneal dialysis (PD) patients and their relationship with calcium-phosphorus metabolism abnormalities and all-cause mortality. Methods: A total of 206 maintenance PD patients admitted from March 2019 to June 2022 were selected. Patients were assessed for the presence of calcium-phosphorus metabolism abnormalities and divided into abnormal and normal groups. Peripheral blood NLR, PLR, and HGB levels were compared between the two groups. The correlation between NLR, PLR, HGB, and blood calcium and phosphorus levels was analyzed. Follow-up was conducted until December 2022, with all-cause mortality as the endpoint event. Patients were divided into the death group and the survival group, and peripheral blood NLR, PLR, and HGB levels were compared. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of NLR, PLR, and HGB for all-cause mortality. Results: In the abnormal group, peripheral blood NLR, PLR, and blood phosphorus levels were higher, while blood calcium levels were lower than those in the normal group (P<0.05). However, there were no statistically significant differences in age, gender, education level, primary disease, dialysis time, and peripheral blood HGB levels between the two groups (P>0.05). In elderly patients undergoing maintenance hemodialysis, peripheral blood NLR and PLR were negatively correlated with blood calcium levels and positively correlated with blood phosphorus levels (P<0.05). However, HGB showed no significant correlation with blood calcium and phosphorus levels (P>0.05). The dialysis time in the death group was longer than that in the survival group. Peripheral blood NLR, PLR, and blood phosphorus levels were higher, while blood calcium levels were lower in the death group compared to the survival group (P<0.05). However, there were no statistically significant differences in age, gender, education level, primary disease, and peripheral blood HGB levels between the two groups (P>0.05). ROC curve analysis showed that the areas under the curve (AUC) for peripheral blood NLR and PLR in predicting all-cause mortality were 0.777 (95% CI: 0.6880.895), respectively. Conclusion: Calcium-phosphorus metabolism abnormalities in maintenance peritoneal dialysis patients are related to peripheral blood NLR and PLR levels. These indicators have a certain predictive value for all-cause mortality in patients.

Key words： Maintenance peritoneal dialysis Neutrophil to lymphocyte ratio Platelet to lymphocyte ratio Hemoglobin Calcium-phosphorus metabolism All cause mortality

基金资助:2020年度安徽省自然科学基金项目,(编号:2008085QH407)

引用本文:

梅吉本, 何静, 陈忠辉, 束长东. 维持性腹膜透析患者外周血NLR PLR HGB水平变化及其与钙磷代谢异常和全因病死率的关系[J]. 河北医学, 2024, 30(1): 93-98.
MEI Jiben, HE Jing, CHEN Zhonghui, et al. Changes in Peripheral Blood NLR PLR and HGB Levels in Maintenance Peritoneal Dialysis Patients and Their Relationship with Calcium-Phosphorus Metabolism Abnormalities and All-Cause Mortality. HeBei Med, 2024, 30(1): 93-98.

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[1] Bello AK,Okpechi IG,Osman MA,et al.Epidemiology of peritoneal dialysis outcomes[J].Nat Rev Nephrol,2022,18(12):779-793.
[2] 刘志超,徐可,布海霞,等.预后营养指数联合NLR,PLR在腹膜透析患者全因死亡中的预测价值[J].天津医药,2023,51(3):290-294.
[3] Meza K,Biswas S,Zhu YS,et al.Tumor necrosis factor-alpha is associated with mineral bone disorder and growth impairment in children with chronic kidney disease[J].Pediatr Nephrol,2021,36(6):1579-1587.
[4] Kidney Disease:Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group.KDIGO 2017 clinical practice guideline update for the diagnosis,evaluation,prevention,and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD) foreword[J].Kidney Int Suppl (2011),2017,7(1):1-59.
[5] Manna GL.Mineral bone disorders in kidney disease patients:the ever-current topic[J].Int Mol Sc,2022,23(20):12223.
[6] Yamada S,Tsuruya K,Kitazono T,et al.Emerging cross-talks between chronic kidney disease-mineral and bone disorder (CKD-MBD) and malnutrition-inflammation complex syndrome (MICS) in patients receiving dialysis[J].Clin Exp Nephrol,2022,26(7):613-629.
[7] Tinti F,Lai S,Noce A,et al.Chronic kidney disease as a systemic inflammatory syndrome:update on mechanisms involved and potential treatment[J].Life (Basel,Switzerland),2021,11(5):419.
[8] 姚寿林,汪珊,夏光云,等.CRP,NLR及PLR联合检测用于老年RA疾病活动度及对患者预后的评估价值[J].中国老年学杂志,2022,42(18):4474-4477.
[9] Lou C,Jin F,Zhao Q,et al.Correlation of serum NLR,PLR and HALP with efficacy of neoadjuvant chemotherapy and prognosis of triple-negative breast cancer[J].Am Transl Res,2022,14(5):3240-3246.
[10] Duan Y,Peng Z,Zhong S,et al.Association between subclinical left ventricular ejection fraction and platelet-to-lymphocyte ratio in patients with peritoneal dialysis[J].Front Med (Lausanne),2022,9:961453.
[11] Liu D,Yang C,Zhou R,et al.High hemoglobin fluctuation was a protective factor for cardiovascular-related death in peritoneal dialysis (PD) patients:a retrospective analysis of 232 patients with PD[J].Clin Lab Anal,2022,36(7):e24548.
[12] Salanova Villanueva L,Gil Giraldo Y,et al.Paricalcitol regulatory effect on inflammatory,fibrotic and anticalcificating parameters in renal patiente.Far beyond mineral bone isease regulation[J].Nefrologia (Engl Ed),2020,40(2):171-179.
[13] 王晓辉,蔡春天,何娟,等.全段甲状旁腺激素,胎球蛋白A,血肌酐血红蛋白比与慢性肾脏病维持性血液透析患者钙磷代谢紊乱的关系及对颈动脉钙化的预测价值[J].临床肾脏病杂志,2022,22(4):277-282.