方味味, 刘桂凌, 李庆根, 赵文曼, 陈晓莉, 李丹丹. NLR和PLR在腹膜透析相关性感染中的诊断价值探讨[J]. 临床肾脏病杂志, 2020, 20(1): 12-18. DOI: 10.3969/j.issn.1671-2390.2020.01.003
    引用本文: 方味味, 刘桂凌, 李庆根, 赵文曼, 陈晓莉, 李丹丹. NLR和PLR在腹膜透析相关性感染中的诊断价值探讨[J]. 临床肾脏病杂志, 2020, 20(1): 12-18. DOI: 10.3969/j.issn.1671-2390.2020.01.003
    shu
    FANG Wei-wei, LIU Gui-ling, LI Qing-gen, ZHAO Wen-man, CHEN Xiao-li, LI Dan-dan. Diagnostic value of NLR and PLR for peritoneal dialysis-related infection[J]. Journal of Clinical Nephrology, 2020, 20(1): 12-18. DOI: 10.3969/j.issn.1671-2390.2020.01.003
    Citation: FANG Wei-wei, LIU Gui-ling, LI Qing-gen, ZHAO Wen-man, CHEN Xiao-li, LI Dan-dan. Diagnostic value of NLR and PLR for peritoneal dialysis-related infection[J]. Journal of Clinical Nephrology, 2020, 20(1): 12-18. DOI: 10.3969/j.issn.1671-2390.2020.01.003
    shu

    NLR和PLR在腹膜透析相关性感染中的诊断价值探讨

    Diagnostic value of NLR and PLR for peritoneal dialysis-related infection

      摘要
    • 摘要: 目的 探讨外周血中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）、血小板与淋巴细胞比值（platelet-to-lymphocyte ratio，PLR）对腹膜透析相关性感染的诊断及预测价值。方法 回顾性分析71例腹膜透析并发相关感染的患者及102例同期入院行腹膜功能及透析充分性评估的维持性腹膜透析患者的临床资料，分别按照是否发生腹膜透析相关性感染、NLR及PLR的最佳截断值进行分组，分析NLR、PLR等指标与腹膜透析相关性感染的关系。应用受试者工作特征曲线（receiver operating characteristic curve，ROC）评价NLR、PLR、NLR联合PLR对腹膜透析相关性感染的诊断及预测价值。结果 相关性分析提示腹膜透析相关性感染与NLR、PLR、腹透液白细胞计数及hs-CRP呈正相关（均P<0.01）；而与血清白蛋白、血镁、血磷呈负相关（均P<0.01）。NLR与腹膜透析相关性感染、PLR、腹透液白细胞计数及hs-CRP呈正相关（均P<0.01）；与血镁及血清白蛋白呈负相关（均P<0.01）；与血磷无相关性（P>0.05）。PLR与腹膜透析相关性感染、NLR、腹透液白细胞计数及hs-CRP呈正相关（均P<0.01）；与血镁、血磷及血清白蛋白呈负相关（均P<0.05）。单因素Logistic回归显示低血清白蛋白（OR=0.808，95% CI 0.748~0.874，P<0.01）、低血镁（OR=0.001，95% CI 0.000~0.015，P<0.01）、低血磷（OR=0.324，95% CI 0.165~0.635，P=0.01）、高hs-CRP（OR=1.246，95% CI 1.149~1.351，P<0.01）、高NLR（OR=1.570，95% CI 1.315~1.815，P<0.01）、高PLR（OR=1.010，95% CI 1.006~1.014，P<0.01）是腹膜透析相关性感染的危险因素；多因素分析显示低血清白蛋白（OR=0.837，95% CI 0.704~0.995，P=0.043）、高hs-CRP（OR=1.296，95% CI 1.149~1.461，P<0.01）及高NLR（OR=1.522，95% CI 1.055~2.195，P=0.025）是腹膜透析相关性感染的危险因素。从ROC曲线可以看出，NLR、PLR、NLR联合PLR及hs-CRP诊断腹膜透析相关性感染的敏感度分别为64.8%、53.5%、94.4%、93.0%，特异度分别为87.3%、87.3%、98.0%、90.2%。结论 与腹膜透析未发生相关性感染的患者相比，腹膜透析相关感染人群的NLR、PLR、腹透液白细胞计数及hs-CRP水平明显升高，而白蛋白、血镁、血磷明显降低。且高NLR、高hs-CRP、低血清白蛋白是腹膜透析相关性感染危险因素。此外，NLR联合PLR对腹膜透析相关性感染的临床诊断敏感性及特异性均优于hs-CRP。

       

      Abstract: Objective To investigate the diagnostic and predictive value of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) for peritoneal dialysis(PD)-related infection. Methods Clinical data of 71 PD patients complicated with PD related infections and 102 maintenance PD patient hospitalized in the same period were retrospectively analyzed for evaluation of peritoneal function and dialysis adequacy. The patients were divided into two groups according to occurrence of peritoneal dialysis-related infection or the best cut-off values of NLR and PLR, so as to analyze the relationship of NLR, and PLR with PD related infection. Receiver operating characteristic curve (ROC) was used to evaluate diagnostic and predictive value of NLR or PLR alone and combination between NLR and PLR for PD related infection. Results A total of 173 cases were included in the study. Spearman correlation analysis suggested, PD related infection exhibited positive correlation with NLR, PLR, white blood cell count in peritoneal dialysate and hypersensitivity C-reaction protein (hs-CRP) (all P<0.05); and had negative correlation with serum albumin, blood magnesium and blood phosphorus (all P<0.05). NLR had positive correlation with PD related infection, PLR, white blood cell count in peritoneal dialysate and hs-CRP (all P<0.05); negative correlation with blood magnesium and serum albumin (all P<0.05); and no correlation with blood phosphorus. PLE was positively correlated with PD related infection, NLR, white blood cell count in peritoneal dialysate and hs-CRP (all P<0.05); and negatively correlated with blood magnesium, blood phosphorus and serum albumin(all P<0.05). Univariate Logistic regression analysis showed, low serum albumin (OR=0.808,95% CI 0.748~0.874, P<0.001), low blood magnesium (OR=0.001,95% CI 0.000~0.015, P<0.001), low blood phosphorus (OR=0.324,95% CI 0.165~0.635, P=0.001), high hs-CRP (OR=1.246,95% CI 1.149~1.351, P<0.001), and high NLR (OR=1.570, 95% CI 1.315~1.815, P<0.001) and high PLR (OR=1.010,95% CI 1.006~1.014, P<0.001) were risk factors for PD related infection. Multivariate analysis showed that low serum albumin (OR=0.837,95% CI 0.704~0.995, P=0.043), high hs-CRP (OR=1.296,95% CI 1.149~1.461, P<0.001) and high NLR (OR=1.522,95% CI 1.055~2.195, P=0.025) were risk factors for PD-related infection. From the ROC curve, it can be seen that the sensitivity and specificity of NLR, PLR, NLR and PLR combination and hs-CRP in the diagnosis of PD-related infection were 64.8%,87.3%;53.5%, 87.3%;94.4%, 98.0%; 93.0%, 90.2%, respectively. Conclusions The levels of NLR, PLR, white blood cell count in peritoneal dialysate and hs-CRP in peritoneal dialysis patients with PD-related infection were significantly higher than those without PD-related infection, while albumin, serum magnesium and serum phosphorus were significantly decreased. High NLR, high hs-CRP and low serum albumin are risk factors for peritoneal dialysis-associated infection. In addition, the sensitivity and specificity of NLR combined with PLR in the clinical diagnosis of peritoneal dialysis-related infection were higher than those of hs-CRP.

       

      • HTML全文
      • 参考文献(26)
      • 相关文章
      • 施引文献
    • 资源附件(0)

    /

    返回文章
    返回