Neuen Brendon L, Leather Nicole, Greenwood Alice M, Gunnarsson Ronny, Cho Yeoungjee, Mantha Murty L
a Department of Renal Medicine , Cairns Hospital , Cairns , Queensland , Australia .
b College of Medicine and Dentistry , James Cook University , Cairns , Queensland , Australia .
Ren Fail. 2016;38(1):70-6. doi: 10.3109/0886022X.2015.1104990. Epub 2015 Nov 5.
Neutrophil-lymphocyte ratio (NLR) is a marker of systemic inflammation that has been shown to predict mortality in patients with malignancies, ischemic heart disease and peripheral vascular disease. Its prognostic value in hemodialysis patients is unclear. The aims of this study were to: (i) explore the relationship between NLR and other biochemical parameters and (ii) to examine the value of NLR as a predictor of cardiovascular and all-cause mortality in hemodialysis patients. The study included all the incident hemodialysis patients from a single center between 2007 and 2012. NLR was calculated using samples obtained 3 months after commencing hemodialysis. One hundred seventy hemodialysis patients were included with a median follow-up of 37 months. There were 54 deaths (32%). NLR was positively correlated with C-reactive protein (r = 0.24, p = 0.0023) and negatively correlated with hemoglobin (r = -0.27, p = 0.00048), albumin (r = -0.23, p = 0.0034) and total cholesterol (r = -0.17, p = 0.049) levels. In multivariate Cox regression, NLR was independently associated with both all-cause mortality (adjusted hazard ratio [HR] 1.4; 95% confidence interval [CI], 1.2-1.6; p ≤ 0.0001) and cardiovascular death (HR 1.3, 95% CI 1.1-1.6, p = 0.0032). Other predictors of all-cause mortality were age (HR 1.6 per decade; 95% CI, 1.2-2.1; p = 0.0017), body mass index (HR 0.93; 95% CI, 0.88-0.98; p = 0.0047), albumin (HR 0.91; 95% CI, 0.86-0.97; p = 0.0035) and peripheral vascular disease (HR 2.7; 95% CI, 1.4-5.1; p = 0.0023). NLR is a practical, cost-efficient and easy to use predictor of cardiovascular and all-cause mortality in incident hemodialysis patients.
中性粒细胞与淋巴细胞比值（NLR）是全身炎症的一个标志物，已被证明可预测恶性肿瘤、缺血性心脏病和外周血管疾病患者的死亡率。其在血液透析患者中的预后价值尚不清楚。本研究的目的是：（i）探讨NLR与其他生化参数之间的关系，以及（ii）检验NLR作为血液透析患者心血管和全因死亡率预测指标的价值。该研究纳入了2007年至2012年间来自单一中心的所有新发血液透析患者。NLR使用开始血液透析3个月后采集的样本进行计算。共纳入170例血液透析患者，中位随访时间为37个月。有54例死亡（32%）。NLR与C反应蛋白呈正相关（r = 0.24，p = 0.0023），与血红蛋白（r = -0.27，p = 0.00048）、白蛋白（r = -0.23，p = 0.0034）和总胆固醇（r = -0.17，p = 0.049）水平呈负相关。在多变量Cox回归分析中，NLR与全因死亡率（校正风险比[HR] 1.4；95%置信区间[CI]，1.2 - 1.6；p≤0.0001）和心血管死亡（HR 1.3，95% CI 1.1 - 1.6，p = 0.0032）均独立相关。全因死亡率的其他预测因素包括年龄（每十年HR 1.6；95% CI，1.2 - 2.1；p = 0.0017）、体重指数（HR 0.93；95% CI，0.88 - 0.98；p = 0.0047）、白蛋白（HR 0.91；95% CI，0.86 - 0.97；p = 0.0035）和外周血管疾病（HR 2.7；95% CI，1.4 - 5.1；p = 0.0023）。NLR是新发血液透析患者心血管和全因死亡率的一个实用、经济高效且易于使用的预测指标。
