Li Han, Lu Xiangxue, Xiong Ruifang, Wang Shixiang
Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Nephrology Faculty, Capital Medical University, Beijing, China.
Mediators Inflamm. 2017;2017:9327136. doi: 10.1155/2017/9327136. Epub 2017 Feb 21.
The neutrophil-to-lymphocyte ratio (NLR) is a novel simple biomarker of inflammation. It has emerged as a predictor of poor prognosis in cancer and cardiovascular disease in general population. But little was known of its prognostic value in chronic hemodialysis (HD) patients. Here we investigated the association between NLR and cardiovascular risk markers, including increased pulse pressure (PP), left ventricular mass index (LVMI) and intima-media thickness (IMT), and mortality in HD patients. Two hundred and sixty-eight HD patients were enrolled in this study and were followed for 36 months. The primary end point was all-cause mortality and cardiovascular mortality. Multivariable Cox regression was used to calculate the adjusted hazard ratios for NLR on all-cause and cardiovascular survival. We pinpointed that higher NLR in HD patients was a predictor of increased PP, LVMI, and IMT; HD patients with higher NLR had a lower survival at the end of the study; furthermore, high NLR was an independent predictor of all-cause and cardiovascular mortality when adjusted for other risk factors. In conclusion, higher NLR in HD patients was associated with cardiovascular risk factors and mortality.
中性粒细胞与淋巴细胞比值(NLR)是一种新型的简单炎症生物标志物。它已成为普通人群中癌症和心血管疾病预后不良的预测指标。但对于其在慢性血液透析(HD)患者中的预后价值知之甚少。在此,我们研究了NLR与心血管风险标志物之间的关联,这些标志物包括脉压(PP)升高、左心室质量指数(LVMI)和内膜中层厚度(IMT),以及HD患者的死亡率。本研究纳入了268例HD患者,并对其进行了36个月的随访。主要终点是全因死亡率和心血管死亡率。采用多变量Cox回归分析计算NLR对全因生存和心血管生存的调整后风险比。我们发现,HD患者中较高的NLR是PP、LVMI和IMT升高的预测指标;NLR较高的HD患者在研究结束时生存率较低;此外,在调整其他风险因素后,高NLR是全因死亡率和心血管死亡率的独立预测指标。总之,HD患者中较高的NLR与心血管危险因素和死亡率相关。