计算炎症标志物来源于全血细胞计数结果，以及常规实验室和临床数据，可以预测慢性腹膜透析患者急性腹膜炎的治疗失败。
Calculated inflammatory markers derived from complete blood count results, along with routine laboratory and clinical data, predict treatment failure of acute peritonitis in chronic peritoneal dialysis patients.
机构信息
Department of Nephrology, Liaoning Translational Medicine Center of Nephrology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
College of Integrative Medicine, Dalian Medical University, Dalian, China.
出版信息
Ren Fail. 2023 Dec;45(1):2179856. doi: 10.1080/0886022X.2023.2179856.
BACKGROUND & AIMS: Complete blood count (CBC)-derived inflammatory markers are predictive biomarkers for the prognosis of many diseases. However, there was no study on patients with peritoneal dialysis-associated peritonitis (PDAP). We aimed to investigate the value of these markers in predicting treatment failure of acute peritonitis in chronic PD patients.
METHODS
The records of 138 peritonitis episodes were reviewed and divided into treatment success or failure groups in a single center for 10 years. CBC-derived markers and other routine data were recorded before peritonitis treatment was initiated. Univariate and multivariate regression analyses and the receiver operating characteristic (ROC) curve about the predictors of treatment outcomes were performed.
RESULTS
Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and derived NLR were significantly higher in the failure group. Univariate logistic regression results showed that NLR and PLR were risk factors of treatment outcomes. The backward stepwise multivariate logistic regression results demonstrated that NLR [adjusted odds ratio (aOR), 1.376; 95% confidence intervals (CI), 1.105-1.713; .004], PLR (aOR, 1.010; 95%CI, 1.004-1.017; .002) were risk factors, but hemoglobin-to-lymphocyte ratio (HLR) (aOR, 0.977; 95%CI, 0.963-0.991; .001), and SII (aOR, 0.999; 95%CI, 0.998-1.000; .040) were protective factors. A combination of age, PD vintage, Gram-positive peritonitis, staphylococcus aureus, culture-negative, NLR, PLR, HLR, and SII would improve prognostic performance. The area under this ROC curve was 0.85, higher than other factors.
CONCLUSIONS
NLR, PLR, HLR, and SII were associated with PDAP outcomes. Age, PD vintage, NLR, and PLR were significant risk factors in PDAP patients.
背景与目的
全血细胞计数（CBC）衍生的炎症标志物是许多疾病预后的预测生物标志物。然而，针对腹膜透析相关性腹膜炎（PDAP）患者，尚无相关研究。本研究旨在探讨这些标志物在预测慢性 PD 患者急性腹膜炎治疗失败中的价值。
方法
回顾性分析了单中心 10 年内 138 例腹膜炎发作的记录，并将其分为治疗成功和治疗失败组。在开始腹膜炎治疗之前，记录了 CBC 衍生标志物和其他常规数据。对预测治疗结局的因素进行了单因素和多因素回归分析及受试者工作特征（ROC）曲线分析。
结果
治疗失败组的中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）、全身免疫炎症指数（SII）和衍生 NLR 明显更高。单因素 logistic 回归结果显示，NLR 和 PLR 是治疗结局的危险因素。向后逐步多因素 logistic 回归结果表明，NLR[调整后比值比（aOR），1.376；95%置信区间（CI），1.105-1.713；.004]、PLR（aOR，1.010；95%CI，1.004-1.017；.002）是危险因素，但血红蛋白与淋巴细胞比值（HLR）（aOR，0.977；95%CI，0.963-0.991；.001）和 SII（aOR，0.999；95%CI，0.998-1.000；.040）是保护因素。年龄、PD 龄、革兰阳性腹膜炎、金黄色葡萄球菌、培养阴性、NLR、PLR、HLR 和 SII 的组合可改善预后预测效能。ROC 曲线下面积为 0.85，高于其他因素。
结论
NLR、PLR、HLR 和 SII 与 PDAP 结局相关。年龄、PD 龄、NLR 和 PLR 是 PDAP 患者的显著危险因素。
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