外周血NLR、NHR在终末期肾脏病患者颈动脉粥样硬化中的临床价值分析

杨琨; 李沁芸; 王鲸竹; 刘佳丽; 唐金城; 张和平

doi:10.16016/j.2097-0927.202111207

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外周血NLR、NHR在终末期肾脏病患者颈动脉粥样硬化中的临床价值分析

临床医学 | 更新时间：2026-01-09

- 外周血NLR、NHR在终末期肾脏病患者颈动脉粥样硬化中的临床价值分析
- Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease
- 陆军军医大学学报 2022年44卷第13期页码：1395-1400
- 作者机构：
  
  637000 四川南充，川北医学院附属医院肾内科
- 作者简介：
  
  [张和平，E-mail: hepingzhang790316@163.com ZHANG Heping, E-mail: hepingzhang790316@163.com
- 基金信息：
  
  四川省卫生健康委员会科研课题(19ZD006);南充市校科技战略合作专项课题(20SXQT0287)
- DOI：10.16016/j.2097-0927.202111207
  中图分类号： R446.11;R543.4;R692.5
- 收稿：2021-11-29，
  
  修回：2022-03-15，
  
  纸质出版：2022-07-15
- 稿件说明：
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杨琨, 李沁芸, 王鲸竹, 等. 外周血NLR、NHR在终末期肾脏病患者颈动脉粥样硬化中的临床价值分析[J]. 陆军军医大学学报, 2022,44(13):1395-1400.

Kun YANG, Qinyun LI, Jingzhu WANG, et al. Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease[J]. Journal of Army Medical University, 2022, 44(13): 1395-1400.
杨琨, 李沁芸, 王鲸竹, 等. 外周血NLR、NHR在终末期肾脏病患者颈动脉粥样硬化中的临床价值分析[J]. 陆军军医大学学报, 2022,44(13):1395-1400. DOI： 10.16016/j.2097-0927.202111207.

Kun YANG, Qinyun LI, Jingzhu WANG, et al. Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease[J]. Journal of Army Medical University, 2022, 44(13): 1395-1400. DOI： 10.16016/j.2097-0927.202111207.

摘要

目的

探讨中性粒细胞/淋巴细胞比值(NLR)、中性粒细胞/高密度脂蛋白比值(NHR)在终末期肾脏病(end-stage renal disease

ESRD)患者颈动脉粥样硬化(carotid atherosclerosis

CAS)中的临床价值。

方法

选取2017年1月至2021年1月在川北医学院附属医院肾内科住院治疗的220例ESRD患者[GFR

15 mL/(min·1.73 m

)

]

作为研究对象，根据颈部彩色多普勒超声结果，分为颈动脉粥样硬化组(CAS组，80例)和非颈动脉粥样硬化组(非CAS组，140例)。收集患者的一般资料，并检查血常规、血生化指标及hs-CRP，计算NLR、MHR、PLR、NHR值。

结果

与非CAS组比较，CAS组年龄、NLR、NHR、PLR、MHR增高，血红蛋白、白蛋白、HDL降低，差异具有统计学意义(

0.05)。多因素Logistic回归分析显示，高龄(

=1.067

95%

: 1.035~1.099

0.001)，NLR升高(

=1.295

95%

: 1.066~1.574

=0.009)，NHR升高(

=2.143

95%

: 1.620~2.834

0.001)是ESRD患者发生CAS的危险因素

血红蛋白升高(

=0.945

95%

: 0.923~0.967

0.001)是ESRD患者发生CAS的保护因素。ROC曲线分析结果显示，NLR(AUC: 0.759

95%

: 0.696~0.822

0.000 1)、NHR(AUC: 0.755

95%

: 0.691~0.820

0.000 1)、两者联合后(AUC: 0.793

95%

: 0.733~0.853

0.000 1)，对ESRD患者发生CAS有一定的预测价值。

结论

NLR、NHR作为炎性指标，是ESRD患者发生CAS的独立危险因素，两者联合对ESRD患者发生CAS可能具有预测价值。

Abstract

Objective

To investigate the clinical value of neutrophil/lymphocyte ratio (NLR) and neutrophil/high-density lipoprotein cholesterol ratio (NHR) for carotid atherosclerosis (CAS) in patients with end-stage renal disease (ESRD).

Methods

A total of 220 ESRD patients [glomerular filtration rate

15 mL/(min·1.73 m

)

]

admitted in our department from January 2017 to January 2021 were recruited in this study. According to the results of neck color Doppler ultrasound

they were divided into CAS group (

=80) and non-CAS group (

=140). Their general data

results of blood routine test

biochemical indexes and hs-CRP level were collected

and then NLR

NHR

monocyte to high-density lipoprotein cholesterol ratio (MHR)

and platelet to lymphocyte ratio (PLR) were calculated.

Results

The CAS group had significant older age

higher NLR

NHR

PLR and MHR

and lower hemoglobin

albumin and HDL levels when compared with the non-CAS group (

0.05). Multivariate logistic regression analysis showed that older age (

=1.067

95%

: 1.035~1.099

0.001)

elevated NLR (

=1.295

95%

: 1.066~1.574

=0.009)

and increased NHR (

=2.143

95%

: 1.620~2.834

0.001) were risk factors for CAS

and risen hemoglobin (

=0.945

95%

: 0.923~0.967

0.001) were protective factors for CAS in ESRD patients. ROC curve analysis indicated that NLR (AUC=0.759

95%

: 0.696~0.82

0.000 1)

NHR (AUC=0.755

95%

: 0.691~0.820

0.000 1) and their combination (AUC=0.793

95%

: 0.733~0.853

0.000 1) had certain predictive values for CAS in ESRD patients.

Conclusion

NLR and NHR

as inflammatory indexes

are independent risk factors for CAS in ESRD patients. Their combination might have better predictive value for CAS in these patients.

关键词

Keywords

references

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