Department of Nephrology, The Third People's Hospital of Yunnan Province, Kunming, Yunnan, P.R. China.
Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R China.
Medicine (Baltimore). 2021 Jul 23;100(29):e26591. doi: 10.1097/MD.0000000000026591.
The goal of this work was to investigate the potential significance of neutrophil-lymphocyte ratio (NLR) in patients treated with maintenance hemodialysis (MHD).Herein, we retrospectively reviewed the electronic medical records of 100 patients with end-stage renal failure who were treated with MHD. All patients enrolled in this study met the inclusion criteria and were followed. The differences in each indicator between the two groups were compared using the Wilcoxon rank-sum test. On the other hand, Spearman correlation and logistic regression analysis were used to explore the correlation and risk factors for pulmonary infection between NLR and other indicators. Finally, we determined the optimal cut-off values for NLR, hypersensitive c-reactive protein (hs-CRP), and procalcitonin (PCT) diagnosis of pulmonary infection using the receiver operating characteristic curve.We found that NLR was positively correlated with age, PCT, hs-CRP, and hospital stay, but negatively correlated with hemoglobin, red blood cell, and Albumin. The expression levels of PCT, hs-CRP, and NLR in the infected group decreased significantly than those before treatment. Multiple regression analysis revealed that NLR is an important independent risk factor for MHD patients with pulmonary infection. Additionally, receiver operating characteristic curve analysis showed that the sensitivity, specificity, and area under the curve were 87.76%, 100%, and 0.920 when using NLR combined with hs-CRP to predict pulmonary infection in MHD patients, whereas that of NLR combined with PCT were 87.76%, 96.08%, and 0.944, respectively.Findings from this study suggested that NLR is an independent risk factor for MHD patients with pulmonary infection, which can effectively predict pulmonary infection. Moreover, sensitivity and specificity were greatly enhanced when using NLR combined with PCT/hs-CRP to predict pulmonary infection in MHD patients.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）在维持性血液透析（MHD）患者中的潜在意义。本研究回顾性分析了 100 例接受 MHD 治疗的终末期肾衰竭患者的电子病历。所有纳入本研究的患者均符合纳入标准并接受随访。采用 Wilcoxon 秩和检验比较两组间各指标的差异。另一方面，采用 Spearman 相关和逻辑回归分析探讨 NLR 与其他指标之间的相关性和肺感染的风险因素。最后，我们通过受试者工作特征曲线确定 NLR、超敏 C 反应蛋白（hs-CRP）和降钙素原（PCT）诊断肺感染的最佳截断值。我们发现 NLR 与年龄、PCT、hs-CRP 和住院时间呈正相关，与血红蛋白、红细胞和白蛋白呈负相关。感染组 PCT、hs-CRP 和 NLR 的表达水平明显低于治疗前。多因素回归分析显示，NLR 是 MHD 合并肺感染患者的重要独立危险因素。此外，ROC 曲线分析显示，NLR 联合 hs-CRP 预测 MHD 患者肺感染的敏感性、特异性和曲线下面积分别为 87.76%、100%和 0.920，而 NLR 联合 PCT 分别为 87.76%、96.08%和 0.944。本研究表明，NLR 是 MHD 合并肺感染患者的独立危险因素，可有效预测肺感染。此外，NLR 联合 PCT/ hs-CRP 预测 MHD 患者肺感染的敏感性和特异性显著提高。
