Department of Blood Purification, General Hospital of Northern Theatre Command, Shenyang, Liaoning, China.
Ren Fail. 2023;45(2):2258228. doi: 10.1080/0886022X.2023.2258228. Epub 2023 Sep 19.
The aim of this study was to further assess whether the platelet-to-lymphocyte ratio (PLR) is independently associated with all-cause mortality and cardiovascular mortality in maintenance hemodialysis (MHD) patients.
From January 1, 2014, to December 31, 2014, patients undergoing regular hemodialysis in the Blood Purification Center of the General Hospital of Northern Theatre Command were retrospectively selected. A total of 303 MHD patients were enrolled in accordance with the inclusion and exclusion criteria. For each patient, the endpoint of follow-up was either death or December 31, 2021. The primary endpoints were all-cause and cardiovascular death. A receiver operating characteristic (ROC) curve was drawn to detect the predictive ability of PLR, and the optimal critical value of PLR was determined to be 107.57. Kaplan-Meier curves and Cox proportional analysis were used to assess the prognostic value of PLR. We used the same method to evaluate the correlation between the neutrophil-to-lymphocyte ratio (NLR) and the prognosis of MHD patients.
At the end of follow-up, 128 MHD patients had progressed to all-cause death, and 73 MHD patients had progressed to cardiovascular death. In multivariate Cox regression, both the high PLR group and the high NLR group were independently associated with all-cause mortality (HR 2.608, 95% CI 1.579-4.306, < .001 vs. HR 1.634, 95% CI 1.023-2.610, = .04). Only high PLR expression was associated with cardiovascular mortality (HR 3.379, 95% CI 1.646-6.936, = .001).
High PLR levels can independently predict all-cause and cardiovascular mortality in MHD patients.
本研究旨在进一步评估血小板与淋巴细胞比值（PLR）是否与维持性血液透析（MHD）患者的全因死亡率和心血管死亡率独立相关。
回顾性选取 2014 年 1 月 1 日至 2014 年 12 月 31 日在北部战区总医院血液净化中心接受常规血液透析的患者。根据纳入和排除标准，共纳入 303 例 MHD 患者。每位患者的随访终点为死亡或 2021 年 12 月 31 日。主要终点为全因和心血管死亡。绘制受试者工作特征（ROC）曲线以检测 PLR 的预测能力，并确定 PLR 的最佳临界值为 107.57。使用 Kaplan-Meier 曲线和 Cox 比例分析评估 PLR 的预后价值。我们使用相同的方法评估中性粒细胞与淋巴细胞比值（NLR）与 MHD 患者预后的相关性。
随访结束时，128 例 MHD 患者发生全因死亡，73 例 MHD 患者发生心血管死亡。多变量 Cox 回归分析显示，高 PLR 组和高 NLR 组均与全因死亡率独立相关（HR 2.608，95%CI 1.579-4.306， < .001 比 HR 1.634，95%CI 1.023-2.610， = .04）。只有高 PLR 表达与心血管死亡率相关（HR 3.379，95%CI 1.646-6.936， = .001）。
高 PLR 水平可独立预测 MHD 患者的全因和心血管死亡率。
