【摘要】目的观察中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio，NLR)对自体动静脉内瘘(autologous arteriovenous fistulas，AVF)狭窄经皮腔内血管成形术(percutaneous transluminal angioplasty，PTA)术后通畅率的影响。方法纳入2018 年6 月～2019 年7 月在安徽医科大学第二附属医院肾内科成功行PTA 术患者84 例，收集临床和随访资料。根据术前NLR 水平分为高NLR 组和低NLR 组，对比2 组基线资料，采用Log-rank 检验分析2 组间通畅率，使用COX 多因素回归分析影响PTA 术后通畅率的因素。结果男47 例，女37 例，平均随访时间(263.51±120.41)d。高NLR 组较低NLR 组术后再狭窄率高(χ 2=7.683，P=0.006)，高NLR 组血镁水平较低(t=2.486,P=0.015)，高NLR 组AVF 通畅率低于低NLR 组(Log Rank检验，χ2=7.885，P=0.005)。结论高NLR 是影响PTA 术后AVF 通畅率的独立危险因素。
【Abstract】Objective To investigate the effect of neutrophil/lymphocyte ratio (NLR) on patency of autologous arteriovenous fistulas (AVF) after percutaneous transluminal angioplasty (PTA). Methods This study consisted of 84 patients with successful PTA treated in the Department of Nephrology, the Second Hospital of Anhui Medical University between June 2018 and July 2019. Their clinical data and follow-up information were recruited. Patients were divided into two groups according to the level of NLR before PTA: high NLR group (n=42) and low NLR group (n=42). Survival analyses and log-rank test were used to compare the patency rate between the two groups. Multivariate Cox regression was used to analyze the interference factors for patency rate. Results There were 47 males and 37 females. The average follow- up time was 263.51±120.41 days. The rEstenosis rate was significantly higher in high NLR group compared to low NLR group (χ2=7.683, P=0.006). Serum magnesium was lower in high NLR group (t=2.486, P=0.015). The patency of AVF was significantly lower in high NLR group than in low NLR group (log rank test: χ2=7.885, P=0.005). Conclusion Higher NLR is an independent risk factor for the patency of AVF after PTA.
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