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    陈蕴, 汤静, 陈安珉, 黄建槐, 夏文亚, 冯锦红. 中性粒细胞淋巴细胞比值、血小板淋巴细胞比值与血液透析患者血管内皮功能及左室肥厚的相关性研究[J]. 徐州医科大学学报, 2023, 43(6): 439-446. DOI: 10.3969/j.issn.2096-3882.2023.06.009
    引用本文: 陈蕴, 汤静, 陈安珉, 黄建槐, 夏文亚, 冯锦红. 中性粒细胞淋巴细胞比值、血小板淋巴细胞比值与血液透析患者血管内皮功能及左室肥厚的相关性研究[J]. 徐州医科大学学报, 2023, 43(6): 439-446. DOI: 10.3969/j.issn.2096-3882.2023.06.009
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    CHEN Yun, TANG Jing, CHEN Anmin, HUANG Jianhuai, XIA Wenya, FENG Jinhong. Correlation of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio with vascular endothelial function and left ventricular hypertrophy in patients undergoing hemodialysis[J]. Journal of Xuzhou Medical University, 2023, 43(6): 439-446. DOI: 10.3969/j.issn.2096-3882.2023.06.009
    Citation: CHEN Yun, TANG Jing, CHEN Anmin, HUANG Jianhuai, XIA Wenya, FENG Jinhong. Correlation of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio with vascular endothelial function and left ventricular hypertrophy in patients undergoing hemodialysis[J]. Journal of Xuzhou Medical University, 2023, 43(6): 439-446. DOI: 10.3969/j.issn.2096-3882.2023.06.009
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    中性粒细胞淋巴细胞比值、血小板淋巴细胞比值与血液透析患者血管内皮功能及左室肥厚的相关性研究

    Correlation of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio with vascular endothelial function and left ventricular hypertrophy in patients undergoing hemodialysis

      摘要
    • 摘要: 目的 探讨血液透析(hemodialysis,HD)患者中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板淋巴细胞比值(platelet to lymphocyte ratio,PLR)与血管内皮功能、左室肥厚(left ventricular hypertrophy,LVH)的关系。方法 入组维持性HD患者107例,根据左室质量指数(left ventricular mass index,LVMI)结果分为LVH组和非LVH组。彩超测定肱动脉血流介导的内皮依赖性血管舒张功能(flow-mediated dilation,FMD),根据FMD值分为3组:血管内皮功能良好组、血管内皮功能一般组、血管内皮功能障碍组。收集所有患者的临床数据、生化指标,对影响FMD的因素进行分析。并将HD患者是否发生LVH作为因变量进行二元logistic回归分析。结果 HD患者中LVH组FMD显著低于非LVH组,收缩压、舒张压、NLR显著高于非LVH组(P<0.05)。血管内皮功能3组间NLR、PLR差异具有统计学意义(P<0.05)。Spearman相关性分析显示FMD与LVMI、糖化血红蛋白、NLR、PLR呈负相关(P<0.05)。以是否血管内皮功能障碍作为因变量,采用二元logistic回归分析显示,年龄、糖化血红蛋白、NLR是其独立危险因素;ROC曲线分析显示,年龄、糖化血红蛋白、NLR预测HD患者发生血管内皮功能障碍的ROC曲线AUC值依次为0.605(95%CI:0.488~0.722)、0.619(95%CI:0.504~0.734)、0.794(95%CI:0.706~0.883),最佳截断值分别为64.00岁、5.85%、3.42,灵敏度分别为38.2%、58.8%、94.1%,特异度分别为17.8%、63.0%、69.9%。以是否发生LVH为因变量,二元logistic回归分析发现NLR是其独立危险因素;ROC曲线分析显示,NLR预测HD患者发生LVH的ROC曲线AUC值为0.671(95%CI:0.567~0.774),最佳截断值为3.49,灵敏度为61.7%,特异度为72.3%。结论 FMD与HD患者LVMI显著相关,年龄、糖化血红蛋白、NLR是血管内皮功能障碍的独立危险因素,NLR是LVH的独立危险因素。

       

      Abstract: Objective To explore the correlation between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (NLR) with vascular endothelial function and left ventricular hypertrophy (LVH) in patients undergoing hemodialysis (HD). Methods A total of 107 patients with maintenance HD were enrolled. According to left ventricular mass index (LVMI), they were divided into two groups:a LVH group and a non-LVH group. The flow-mediated dilation (FMD) of the brachial artery was measured by color ultrasound. According to the value of FMD, they were divided into three groups:a good endothelial function group, a common endothelial function group and an endothelial dysfunction group. Their clinical data and biochemical indexes were collected. The influencing factors of FMD were analyzed. The presence of LVH in HD patients was used as the dependent variable for binary logistic regression analysis.Results For HD patients, the LVH group showed significantly lower FMD, but higher systolic blood pressure, diastolic blood pressure and NLR than the non-LVH group (P<0.05). There were statistical differences in NLR and PLR among the three groups with various vascular endothelial function (P<0.05). Spearman correlation analysis showed that FMD was negatively correlated with LVMI, glycosylated hemoglobin, NLR and PLR (P<0.05). With the vascular endothelial dysfunction as a dependent variable, binary logistic regression analysis was conducted, which indicated that age, glycosylated hemoglobin and NLR were the independent risk factors. According to ROC curve analysis, the AUC values of ROC curves for age, glycosylated hemoglobin and NLR in predicting vascular endothelial dysfunction in HD patients were 0.605 (95%CI:0.488-0.722), 0.619 (95%CI:0.504-0.734) and 0.794 (95%CI:0.706-0.883). The optimal cut-off values were 64.00 years old, 5.85%, and 3.42, with a sensitivity of 38.2%, 58.8%, 94.1%, respectively and a specificity of 17.8%, 63.0%, 69.9%, respectively. With the LVH as a dependent variable, binary logistic regression analysis showed that NLR was an independent risk factor. According to ROC curve analysis, the AUC value of ROC curve for predicting LVH in HD patients by NLR was 0.671 (95%CI:0.567-0.774), where the optimal cut-off value was 3.49, with a sensitivity of 61.7% and a specificity of 72.3%.Conclusions FMD is significantly correlated with LVMI in HD patients. Age, HbA1c and NLR are the independent risk factors for vascular endothelial dysfunction, while NLR is the independent risk factors for LVH.

       

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