摘要
目的 观察腹膜透析后感染性腹膜炎患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、白细胞介素-6(IL-6)水平及中性粒细胞与淋巴细胞比值(NLR)并分析其临床意义.方法 回顾性选取2020年1月至2023年12月青岛大学附属青岛市海慈医院(青岛市中医医院)收治的82例腹膜透析患者为观察组,根据患者是否发生感染性腹膜炎进一步分为感染组(n=29)、未感染组(n=53),另选择同时期、年龄段接近的在本院体检的健康者60名作为对照组.比较观察组与对照组、感染组与未感染组血清NGAL、IL-6水平及NLR.绘制受试者操作特征(ROC)曲线分析血清NGAL、IL-6水平及NLR诊断腹膜透析后感染性腹膜炎的价值.结果 观察组血清NGAL、IL-6水平及NLR分别为(462.79±85.04)μg/L、(22.74±6.18)μg/L、4.62±0.96,均明显高于对照组[(83.26±10.47)μg/L、(4.12±1.36)μg/L、2.59±0.72],差异均有统计学意义(P＜0.05).感染组血清NGAL、IL-6水平及NLR分别为(641.56±112.79)μg/L、(13.92±3.04)μg/L、7.95±1.14,均明显高于对照组[(396.37±94.06)μg/L、(29.76±8.72)μg/L、3.51±0.82],差异均有统计学意义(P＜0.05).经ROC分析,血清NGAL、IL-6水平及NLR单独及联合诊断腹膜透析后感染性腹膜炎的曲线下面积(AUC)分别为 0.831(95％CI:0.767～0.895)、0.899(95％CI:0.859～0.939)、0.775(95％CI:0.696～0.854)、0.957(95％CI:0.932～0.982),敏感度分别为 0.828、0.862、0.758、0.897,特异度分别为0.867、0.811、0.830、0.906.结论 腹膜透析后感染性腹膜炎患者血清NGAL、IL-6水平及NLR明显升高,通过检测以上指标对于诊断腹膜透析后感染性腹膜炎具有较好的价值,且三项指标联合检测可进一步提高诊断价值.
Abstract
Objective To observe the levels of serum neutrophil gelatinase-associated lipid(NGAL),interleukin-6(IL-6)and neutrophil to lymphocyte ratio(NLR)in patients with infectious peritonitis after peritoneal dialysis and to analyzed their clinical significance.Methods A total of 82 patients with peritoneal dialysis admitted to Qingdao Haici Hospital Affiliated to Qingdao University(Qingdao Municipal Hospital of Traditional Chinese Medicine)from January 2020 to December 2023 were selected as the observation group,and were further divided into the infected group(n=29)and the uninfected group(n=53)according to whether the patients had infectious peritonitis.Another 60 healthy people of similar age who come to our hospital at the same period were selected as the control group.Serum levels of NGAL,IL-6 and NLR were compared between the observation group and the control group,the infected group and uninfected group.The value of serum NGAL,IL-6 levels and NLR in the diagnosis of postperitoneal dialysis infectious peritonitis was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum NGAL,IL-6 and NLR in the observation group were(462.79±85.04)μg/L,(22.74±6.18)μg/L and 4.62±0.96,respectively,which were significantly higher than those of the control group[(83.26±10.47)μg/L,(4.12±1.36)μg/L,2.59±0.72],the differences were statistically significant(P＜0.05).The levels of NGAL,IL-6 and NLR in the infected group were(641.56±112.79)μg/L,(13.92±3.04)μg/L and 7.95±1.14,respectively,which were significantly higher than those in the control group[(396.37±94.06)μg/L,(29.76±8.72)μg/L,3.51±0.82],the differences were statistically significant(P＜0.05).According to ROC analysis,the area under the curve(AUC)of serum NGAL,IL-6 and NLR for the diagnosis of postperitoneal dialysis infective peritonitis alone and in combination were0.831(95％CI:0.767-0.895),0.899(95％CI:0.859-0.939)and0.775(95％CI:0.696-0.854),0.957(95％CI:0.932-0.982),the sensitivity was 0.828,0.862,0.758,0.897,and the specificity was 0.867,0.811,0.830,0.906,respectively.Conclusion Serum levels of NGAL,IL-6 and NLR were significantly increased in patients with infective peritonitis after peritoneal dialysis.Detection of the above indicators has a good value in the diagnosis of infective peritonitis after peritoneal dialysis,and the combined detection of the three indicators can further improve the diagnostic value.
基金项目
山东省2022年度医药卫生科研指导项目(2022-WJZD037)
NETL
NSTL
万方数据