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中性粒细胞-淋巴细胞比值与系统性红斑狼疮肾损害的相关性分析
作者:李鎛江  董建华  潘红霞  方梅荣  李婷  肖友文 
单位:乐山市人民医院 肾病内科, 四川 乐山 614000
关键词:系统性红斑狼疮 狼疮性肾炎 肾损害严重度 中性粒细胞-淋巴细胞比值 
分类号:R593.241;R593.242
出版年·卷·期(页码):2021·49·第四期(400-406)
摘要:

目的:探讨中性粒细胞-淋巴细胞比值(NLR)与系统性红斑狼疮(SLE)肾损害的相关性。方法:回顾性分析2016年9月至2020年9月乐山市人民医院收治的206例SLE患者,根据SLE患者有无肾损害分为狼疮性肾炎组(LN组)和无狼疮性肾炎组(无LN组);根据血肌酐水平将LN组患者分为严重肾损害亚组和无严重肾损害亚组,分别比较以上各组的NLR等实验室指标,利用Spearman秩相关分析研究LN组患者NLR和肾损害指标的相关性,运用多因素Logistic回归分析SLE肾损害及严重肾损害的危险因素,应用受试者工作特征(ROC)曲线探讨NLR对SLE肾损害及严重肾损害的诊断效能。结果:(1)LN组NLR显著高于无LN组(P<0.05),严重肾损害亚组NLR显著高于无严重肾损害亚组(P<0.05)。(2)Spearman相关分析显示,LN组NLR与尿素、肌酐、尿酸、24 h尿蛋白均呈正相关(均P<0.05)。(3)多因素Logistic回归显示,NLR是SLE肾损害及其严重肾损害的独立危险因素。(4)ROC曲线显示,NLR诊断SLE肾损害的AUC为0.732,最佳临界值为3.61时诊断效能最高,对应的敏感度为74.49%,特异度为65.74%;NLR诊断SLE严重肾损害的AUC为0.810,最佳临界值为4.92时诊断效能最高,对应的敏感度为85.25%,特异度为61.70%。结论:NLR可作为评估SLE肾损害及其肾损害严重度的潜在血清学指标。

Objective: To retrospectively explore the correlation between neutrophil-to-lymphocyte ratio(NLR) and renal injury in systemic lupus erythematosus(SLE) patients.Methods: A total of 206 cases of SLE in Leshan People's Hospital from September 2016 to September 2020 were enrolled. They were divided into lupus nephritis(LN) group and non-LN group according to renal injury. Based on serum creatinine levels, patients in LN group were further divided into severe renal injury subgroup and non-severe renal injury subgroup. Laboratory indicators such as NLR of the above groups were compared respectively. Spearman's correlation analysis was used to study the correlation between NLR and renal injuryindicators of LN group patients. Multivariate Logistic regression was applied to analyze risk factors for SLE induced renal injury and severe renal injury. Receiver operating characteristics(ROC) curve was applied to explore value of NLR in diagnostic efficacy forSLEinduced renal injury and severe renal injury.Results: (1) The NLRin LN group was significantly higher than that in non-LN group(P<0.05).The NLR in severe renal injury subgroup was significantly higherthan that in non-severe renal injury subgroup(P<0.05). (2) NLR of LN group was positively correlated with urea nitrogen, serum creatinine, uric acid and 24-hour urinary protein(both P<0.05). (3) Multivariate Logistic regression showed that NLR was independently associated with SLE induced renal injury and severe renal injury. (4) ROC curve showed that the area under curve of NLR fordiagnosis of SLE induced renal injury was 0.732. At the most optimal cut-off value of 3.61, the diagnostic sensitivity and specificity were 74.49% and 65.74%, respectively. The area under curve of NLR for evaluating the severity of SLE induced renal injurywas 0.810. At the most optimal cut-off value of 4.92, the diagnostic sensitivity and specificity were 85.25% and 61.70%, respectively.Conclusion: NLR can be used as a potential serological indicator for evaluating SLE induced renal injury and its severity.

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