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血管通路

不同血管通路对维持性血液透析患者中性粒细胞与淋巴细胞比值的影响

  • 刘凤华 ,
  • 许焱
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  • 100028 北京,1应急管理部应急总医院肾内科

收稿日期: 2023-01-13

  修回日期: 2023-06-06

  网络出版日期: 2023-08-12

Effects of different vascular access on neutrophil to lymphocyte ratio in maintenance hemodialysis patients

  • LIU Feng-Hua ,
  • XU Yan
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  • Department of Nephrology, Emergency General Hospital, China Ministry of Emergency Management, Beijing 100028, China

Received date: 2023-01-13

  Revised date: 2023-06-06

  Online published: 2023-08-12

摘要

目的  研究不同血管通路对维持性血液透析患者中性粒细胞与淋巴细胞比值及相关指标的影响。 方法  182例维持性血液透析(maintenance hemodialysis,MHD)患者,其中内瘘组130例,导管组52例,随访2年比较2组全血细胞、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、C反应蛋白(CRP)及部分生化指标的变化。 结果  随访开始2年后导管组与内瘘组相比,淋巴细胞(χ2=-2.338,P =0.019)、NLR(χ2=2.347,P =0.019)、CRP(χ2=2.688,P =0.007)间差异有统计学意义,多元线性回归分析结果显示NLR与白细胞(β=0.287,P<0.001)、血小板计数(β=0.944,P<0.001)呈正相关。随访前后导管组与内瘘组相比,血红蛋白(χ2=2.460,P=0.015)、白蛋白(χ2=4.101,P<0.001)差异有统计学意义。 结论  以中心静脉隧道导管作为血管通路的维持性血液透析患者微炎症状态更重,NLR更高,贫血和营养不良更严重。

本文引用格式

刘凤华 , 许焱 . 不同血管通路对维持性血液透析患者中性粒细胞与淋巴细胞比值的影响[J]. 中国血液净化, 2023 , 22(08) : 624 -628 . DOI: 10.3969/j.issn.1671-4091.2023.08.013

Abstract

Objective   To analyze the neutrophil to lymphocyte ratio (NLR) in maintenance hemodialysis (MHD) patients using the blood access method of central venous catheterization (CVC) or arterial venous fistula (AVF).  Methods   A   total of 182 MHD patients in our department were enrolled in this study. They were divided into CVC group (n=52) and AVF group (n=130). All of them received routine hemodialysis 3 times a week for at least three months. Changes of blood cells, NLR, serum biochemical indicators, and C-reactive protein (CRP) in the follow-up period of 2 years were compared.  Results   After the follow-up period of 2 years, lymphocyte (χ2=-2.338, P=0.019), NLR (χ2=2.347, P=0.019) and CRP (χ2=2.688, P=0.007) were higher in the CVC group than in the AFV group, and serum albumin and hemoglobin were lower in the CVC group than in the AFV group. Multivariate linear regression showed that NLR was positively correlated with white blood cells (β=0.287, P<0.001) and platelet count (β=0.944, P<0.001). Changes of hemoglobin (χ2=2.460, P=0.015) and albumin (χ2=4.101, P<0.001) during the follow-up period of 2 years were more in the CVC group than in the AVF group.  Conclusions   Patients using CVC as the blood access for MHD have higher degrees of microinflammation, NLR, anemia and malnutrition.

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