陈豪爽, 倪利华, 吴小燕. 中性粒细胞/淋巴细胞比值在原发性干燥综合征肾损害中的临床意义[J]. 临床肾脏病杂志, 2023, 23(11): 881-888. DOI: 10.3969/j.issn.1671-2390.2023.11.001
    引用本文: 陈豪爽, 倪利华, 吴小燕. 中性粒细胞/淋巴细胞比值在原发性干燥综合征肾损害中的临床意义[J]. 临床肾脏病杂志, 2023, 23(11): 881-888. DOI: 10.3969/j.issn.1671-2390.2023.11.001
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    Chen Hao-shuang, Ni Li-hua, Wu Xiao-yan. Clinical significance of neutrophils-to-lymphocytes ratio in renal injury of primary Sjögren's syndrome[J]. Journal of Clinical Nephrology, 2023, 23(11): 881-888. DOI: 10.3969/j.issn.1671-2390.2023.11.001
    Citation: Chen Hao-shuang, Ni Li-hua, Wu Xiao-yan. Clinical significance of neutrophils-to-lymphocytes ratio in renal injury of primary Sjögren's syndrome[J]. Journal of Clinical Nephrology, 2023, 23(11): 881-888. DOI: 10.3969/j.issn.1671-2390.2023.11.001
    shu

    中性粒细胞/淋巴细胞比值在原发性干燥综合征肾损害中的临床意义

    Clinical significance of neutrophils-to-lymphocytes ratio in renal injury of primary Sjögren's syndrome

      摘要
    • 摘要:
      目的  探讨中性粒细胞/淋巴细胞比值（neutrophil-to-lymphocyte ratio, NLR） 与原发性干燥综合征（primary Sjögren’s syndrome, pSS）肾损害的相关性，并评估NLR在pSS肾损害中的临床应用价值。
      方法  本研究纳入2017年1月至2022年6月于武汉大学中南医院肾内科、风湿免疫科确诊为pSS的住院治疗的患者134例，回顾性收集其临床资料，根据有无肾损害分为pSS肾损害组与pSS非肾损害组，比较两组的NLR及其他生化指标，Spearman秩相关分析用于评估pSS患者NLR与肾脏损伤相关指标（肌酐、尿素氮、尿酸、胱抑素C、肾小球滤过率）及炎症相关指标（红细胞沉降率、C反应蛋白）的相关性，使用多因素Logistic回归分析pSS肾损害的危险因素，采用受试者工作特征曲线评估并比较NLR、肾损伤相关指标及炎症相关指标对pSS肾损害的诊断价值。
      结果  （1）pSS肾损害组的NLR水平(3.27(0.137)比1.60(1.20,2.06)明显高于非肾损害组（P＜0.05）。（2） Spearman秩相关分析显示，NLR与肌酐、尿酸、胱抑素C、红细胞沉降率及C反应蛋白呈正相关（均P＜0.05），与肾小球滤过率呈负相关（P＜0.05）。（3） 多因素Logistic回归显示，NLR（OR = 7.036，P＜0.001）是pSS合并肾损害的危险因素。（4） 受试者工作特征曲线显示，NLR诊断pSS肾损害的曲线下面积为0.713，诊断效能最高时截取值为2.30，相对应的敏感度为80%，特异度为91.3%，诊断效能高于肾损伤及炎症相关指标。
      结论  NLR可作为预测pSS发生肾脏损害的生化指标。

       

      Abstract:
      Objective  To explore the relevance between neutrophil-to-lymphocyte ratio (NLR) and renal injury in patients with primary Sjogren's syndrome (pSS) and evaluate the clinical application value of NLR in renal injury of pSS.
      Methods  From January 2017 to June 2022, the relevant clinical data were retrospectively reviewed for 134 hospitalized pSS patients. Based upon the presence or absence of renal injury, they were assigned into two groups of pSS with renal injury and pSS without renal injury. NLR and other laboratory parameters were compared between two groups. Through Spearman's rank correlation analysis, the correlations were examined between NLR and renal injury parameters (creatinine, urea nitrogen, uric acid, cystatin C & glomerular filtration rate) and inflammation-related parameters (erythrocyte sedimentation rate & C-reactive protein). The risk factors of renal injury were explored by multivariate Logistic regression. Receiver operating characteristic (ROC) curve was utilized for comparing the diagnostic efficacy of NLR, renal injury parameters and inflammation-related parameters for renal injury in pSS.
      Results  NLR was markedly elevated in renal injury group than that in renal non-injury group (P<0.05). According to Spearman’s correlation analysis, positive correlation existed between NLR and creatinine, uric acid, cystatin C, erythrocyte sedimentation rate, C-reactive protein (all P<0.05). And negative correlation existed between NLR and glomerular filtration rate (P<0.05). According to multivariate Logistic regression, NLR (OR=7.036, P<0.001) was a risk factor for renal injury in pSS. ROC curve revealed that area under curve (AUC) of NLR in the diagnosis of pSS renal injury was 0.713 with an optimal cut-off value of 2.30. With the highest diagnostic efficiency, there was a sensitivity of 80% and a specificity of 91.3%. It was higher than that of renal injury and inflammation-related parameters.
      Conclusions  NLR may be utilized as a biochemical indicator for predicting renal injury in pSS.

       

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