维持性血液透析患者NPAR与蛋白质能量消耗的相关性研究

Study on the Correlation between NPAR and Protein Energy Wasting in Maintenance Hemodialysis Patients

摘要: 目的：评估新型炎症指标中性粒细胞/白蛋白比值(NPAR)对维持性血液透析(MHD)患者蛋白质能量消耗(PEW)之间的关系。方法：回顾性分析2021年06月至2021年12月在新疆医科大学第一附属医院血液净化中心规律随访的MHD患者的一般资料、实验室指标、完善营养不良炎症评分(MIS)诊断PEW。根据NPAR的3分位间距将研究对象分为3组，比较组间各指标的差异，采用Logistic回归分析NPAR与PEW发病的关系，利用ROC曲线评估NPAR对MHD患者PEW的预测价值。结果：共纳入资料完整的研究对象140例，按NPAR三分位分组(Q1、Q2、Q3)，通过Logistic回归分析，在校正年龄、性别、握力、BMI后，NPAR与MHD患者PEW发病风险仍有关，Q3组PEW发病风险为Q1组患者的3.212 (95% CI 1.074~9.612, P < 0.05)。采用受试者工作特征曲线(ROC曲线)分析，NPAR对MHD患者PEW发病最佳预测阈值1.704，灵敏度62.3%、特异度65.1%，曲线下面积为0.64 (95% CI 0.548~0.732, P < 0.05)。结论：NPAR与MHD患者PEW的发生有关，对MHD患者PEW发病有预测价值。

Abstract: Objective: To assess the relationship between the novel inflammatory index neutrophil/albumin ratio (NPAR) on protein energy expenditure (PEW) in maintenance hemodialysis (MHD) patients. Methods: Retrospective analysis of general data, laboratory indices, and perfect malnutrition inflammation score (MIS) diagnostic PEW of MHD patients who were regularly followed up in the Hemodialysis Center of the First Affiliated Hospital of Xinjiang Medical University from June 2021 to December 2021. The study subjects were divided into 3 groups according to the 3-quartile spacing of NPAR, and the differences of each index between groups were compared using logistic regression analysis of the relationship between NPAR and the onset of PEW, and the predictive value of NPAR for PEW in MHD patients was assessed using ROC curves. Results: A total of 140 subjects with complete data were included in the study, divided into NPAR tertile subgroups (Q1, Q2, Q3). Logistic regression analysis showed that after adjusting for age, gender, grip strength, and BMI, NPAR was still associated with the risk of PEW in MHD patients and the risk of PEW onset in MHD patients was 3.212 (95% CI 1.074~9.612, P < 0.05) in the Q3 group compared with that in the Q1 group by logistic regression analysis. Using subject operating characteristic curve (ROC curve) analysis, the best prediction threshold of NPAR for PEW onset in MHD patients was 1.704, with a sensitivity of 62.3%, specificity of 65.1%, and area under the curve of 0.64 (95% CI 0.548~0.732, P < 0.05). Conclusion: NPAR is associated with the occurrence of PEW in MHD patients and has predictive value for the onset of PEW in MHD patients.