血清T淋巴细胞亚群及PLR、MLR、NLR对尿毒症腹膜透析相关性腹膜炎患者的预测价值

doi:10.3969/j.issn.1671-7171.2023.08.003

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摘要【目的】探讨血清T淋巴细胞亚群及中性粒细胞/淋巴细胞比值(neutrophil-to-lym-phocyteratio,NLR)、淋巴细胞/单核细胞比值(lymphocyte-to-monocyte ratio,MLR)、血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)对尿毒症腹膜透析相关性腹膜炎(PDAP)患者的预测价值。【方法】选取2018年3月至2022年3月在本院住院治疗的119例尿毒症腹膜透析(PD)患者,根据是否合并PDAP分为腹膜炎组和非腹膜炎组。比较两组T淋巴细胞亚群(CD4⁺、CD8⁺、CD4⁺/CD8⁺)、炎症指标水平,分析各指标的相关性及其对PDAP的预测价值。【结果】腹膜炎组CD4⁺、CD4⁺/CD8⁺均高于非腹膜炎组, CD8⁺、T淋巴细胞计数均低于非腹膜炎组,差异均有统计学意义(P<0.05);两组T淋巴细胞百分比比较,差异无统计学意义(P>0.05);腹膜炎组NLR、MLR、PLR、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、降钙素原(procalcitonin,PCT)均高于非腹膜炎组,差异均有统计学意义(P<0.05)。CD4⁺/CD8⁺与NLR呈负相关(r=-0.327,P<0.05),与MLR、hs-CRP呈正相关(r=0.875、r=0.306,P<0.05)。血清CD4⁺、CD8⁺、CD4⁺/CD8⁺、PLR、NLR、MLR、hs-CRP、ESR、PCT预测PDAP的曲线下面积(AUC)分别为0.711、0.365、0.700、0.720、0.886、0.931、0.883、0.802、0.737。【结论】血清T淋巴细胞亚群及PLR、MLR、NLR、hs-CRP、ESR、PCT对PDAP均具有较好的预测价值,其中NLR、MLR特异性最强,具有较高的临床参考价值。

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关键词 ：腹膜炎, 尿毒症, 腹膜透析, T淋巴细胞亚群

Abstract：【Objective】To investigate the predictive value of serum T lymphocyte subsets,neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR) and platelet-to-lymphocyte ratio(PLR) ratio for peritoneal dialysis-associated peritonitis (PDAP)diagnosis. 【Methods】A total of 119 peritoneal dialysis-associated patients who were hospitalized in our hospital from March 2018 to March 2022 were enrolled and divided into the peritonitis group and non-peritonitis group. The differences and correlations of T lymphocyte subsets (CD4⁺,CD8⁺,CD4⁺/CD8⁺) and various inflammatory indicators in each group were compared,and their predictive value for peritoneal dialysis peritonitis was analyzed. 【Results】The CD4⁺ and CD4⁺/CD8⁺ in the peritonitis group were higher than those in the non-peritonitis group,and the differences were statistically significant (P<0.05). CD8⁺ and T lymphocyte counts in the peritonitis group were lower than those in the non-peritonitis group,and the differences were statistically significant (P<0.05). There was no significant difference in the percentage of T lymphocytes between the two groups (P>0.05).However,NLR,MLR,PLR,hs-CRP,erythrocyte sedimentation rate(ESR) and procalcitonin(PCT) in the peritonitis group were higher than those in the non-peritonitis group,and the differences were statistically significant (P<0.05). The CD4⁺/CD8⁺ was negatively correlated with NLR (r=-0.327,P<0.05),positively correlated with MLR (r=0.875,P<0.05),and positively correlated with hs-CRP (r=0.306,P<0.05). The AUC of serum CD4⁺,CD8⁺,CD4⁺/CD8⁺,PLR,NLR,MLR,hs-CRP,ESR,and PCT in predicting peritoneal dialysis-related peritonitis were 0.711,0.365,0.700,0.720,0.886,0.931,0.883,0.802,and 0.737,respectively. 【Conclusion】Serum T lymphocyte subsets,PLR,MLR,NLR,hs-CRP,ESR and PCT have good predictive value for peritoneal dialysis-associated peritonitis. Of which,NLR and MLR have the strongest specificity and higher clinical reference value.

Key words： Peritonitis Uremia Peritoneal Dialysis T-Lymphocyte Subsets

收稿日期: 2023-02-27

中图分类号:

R656.41

基金资助:湖南省卫生健康委基金(编号:202103050563)

通讯作者: ^**E-mail:26545559@qq.com

引用本文:

李怡素, 贺雪, 徐勇, 刘骏, 胡静, 刘纪实. 血清T淋巴细胞亚群及PLR、MLR、NLR对尿毒症腹膜透析相关性腹膜炎患者的预测价值[J]. 医学临床研究, 2023, 40(8): 1128-1131.
LI Yi-su, HE Xue, XU Yong, et al. The Predictive Value of Serum T Lymphocyte Subsets,PLR,MLR and NLR for Peritoneal Dialysis Peritonitis. JOURNAL OF CLINICAL RESEARCH, 2023, 40(8): 1128-1131.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.08.003 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I8/1128