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血细胞指数在ESRD进展中的作用
Duong Thi Ngoc Lan1, Donatella Coradduzza2, Le Van An1
1Department of General Internal Medicine and Endocrinology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
Indian journal of clinical biochemistry : IJCB
|March 24, 2025
概括
某些血细胞指数,包括中性粒细胞与淋巴细胞的比率 (NLR) 和衍生NLR (dNLR),可以预测慢性病 (CKD) 患者的功能快速下降. 然而,这些标志物不能预测到末期病 (ESRD) 的进展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 血液学 血液学 血液学
- 炎症研究 炎症研究
背景情况:
- 慢性病 (CKD) 是一种具有挑战性预后的渐进性疾病.
- 预测功能下降和过渡到末期病 (ESRD) 对患者管理至关重要.
- 目前的CKD评估依赖于EGFR和白蛋白尿症等标记物,但需要新的预测剂.
研究的目的:
- 调查特定血细胞指数在CKD3-4期功能下降的预测价值.
- 评估这些指数预测从CKD过渡到ESRD的能力.
- 为了确定最敏感和最具特异性的血细胞标记物来预测快速的eGFR下降.
主要方法:
- 对377名CKD3-4期患者的回顾性分析.
- 评价血细胞指数:绝对中性粒细胞数 (ANC),中性粒细胞/淋巴细胞比率 (NLR),血小板/淋巴细胞比率 (PLR),衍生的NLR (dNLR),平均血小板体积 (MPV),系统性炎症总指数 (AISI) 和系统性炎症指数 (SII).
- 包括ROC曲线分析在内的统计分析,以确定eGFR下降和ESRD过渡的预测准确度.
主要成果:
- ANC,MPV,NLR,PLR,dNLR和SII独立地预测了eGFR的快速下降.
- NLR (切断值3.36) 和dNLR (切断值2.45) 显示出对eGFR下降的预测能力最高 (AUC分别为0.877和0.849).
- 没有一个被评估的血细胞指数独立预测过渡到ESRD.
结论:
- NLR和dNLR是有价值的,非侵入性生物标志物,用于预测慢性病患者的功能迅速下降.
- 这些炎症标志物可能有助于对CKD进展的风险分层.
- 血细胞指数似乎无法预测最终的转变为ESRD.
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