摘要
【目的】探讨单核细胞/高密度脂蛋白(HDL)比值(MHR)与慢性肾脏病(CKD)分期的关系及对心血管事件的预测价值。【方法】180例无心血管事件的非血透CKD 3~5期患者,根据肾小球率过滤(GFR)水平分为A组(CKD 3期,65例);B组(CKD 4期,55例);C组:CKD 5期,60例)。根据6个月内有无心血管事件发生分为心血管事件组(n=75例)和非心血管事件组(n=105例)。同时期健康体检者40例作为对照组。比较其血常规、HDL、肌酐、尿素氮和NT-proBNP水平及GFR值,MHR值。Spearman相关性分析MHR与GFR、NT-proBNP之间的关系。绘制受试者工作曲线(ROC曲线)分析MHR和NT-proBNP对CKD患者心血管事件的预测价值。【结果】随着CKD分期的增加,MHR和NT-proBNP水平呈逐渐上升趋势,其水平高低为C组>B组>A组>对照组(P<0.05);心血管事件组MHR和NT-proBNP水平明显高于非心血管事件组(P<0.05);CKD患者中MHR与GFR呈负相关性(P<0.01),MHR与NT-proBNP呈正相关性(P<0.01);CKD患者MHR和NT-proBNP对心血管事件诊断的ROC曲线下面积分别为0.958和0.932,诊断敏感性分别为92%和86.7%,特异性分别为92.6%和89.6%(P<0.05)。【结论】CKD患者心血管事件的发生与炎症状态存在密切关系,MHR对CKD患者心血管事件发生的预测价值优于传统指标。
【Objective】To investigate the relationship of monocyte/high-density lipoprotein ratio(MHR)with chronic kidney disease(CKD)stage and predictive value of cardiovascular events in patients with CKD.【Methods】A total of 180 patients with non-hemodialysis CKD(stage 3 to 5)in our hospital were collected for the study.According to the level of glomerular rate filtration(GFR),patients were divided into group A(CKD stage 3,n=65 cases),group B(CKD stage 4,n=55 cases)and group C(CKD stage 5,n=60 cases).They further were divided into the cardiovascular event group(n=75 cases)and non-cardiovascular event group(n=105 cases)depending on cardiovascular events occurred within 6 months of follow-up.There were 40 healthy volunteers enrolled in the control group.Blood routine,high-density lipoprotein(HDL),creatinine,urea nitrogen,NT-proBNP,GFR and MHR were recorded and compared among groups.The relationship of MHR with GFR and NT-proBNP was analyzed by Spearman correlation analysis.The predictive value of MHR and NT-proBNP on cardiovascular events in patients with CKD was analyzed by drawing the ROC curve.【Results】The levels of MHR and NT-proBNP increased gradually with the increase of CKD stages,showing that the level of group C>group B>group A>the control group(P<0.05).The levels of MHR and NT-proBNP in patients with cardiovascular events were significantly higher than those in non-cardiovascular events(P<0.05).In patients with CKD,MHR was negatively correlated with GFR(P<0.01),while MHR was positively correlated with NT-proBNP(P<0.01).The area under the ROC curve for diagnosis of cardiovascular events by MHR and NT-proBNP in CDK patients were 0.958 and 0.932,respectively.The diagnostic sensitivities were 92%and 86.7%,respectively,and the specificity were 92.6%and 89.6%,respectively.【Conclusion】There is a close relationship between the occurrence of cardiovascular events and inflammatory state in CKD patients.MHR is superior to traditional indicators in predicting the occurrence of cardiovascular events in CKD patients.
作者
杨曦
华雪莲
YANG Xi;HUA Xue-lian(Clinical Laboratory,Taikang Xianlin Drum Tower Hospital,Nanjing,Jiangsu,210046)
出处
《医学临床研究》
CAS
2019年第11期2157-2160,共4页
Journal of Clinical Research
关键词
肾疾病
慢性病
心血管疾病
Kidney Diseases
Chronic Disease
Cardiovascular Diseases
