摘要
目的探讨中性粒细胞百分比/白蛋白比值(NPAR)与特发性膜性肾病(IMN)患者危险分层、预后的关系。方法选取2017年2月至2022年12月阜阳市人民医院收治的244例IMN患者作为研究对象。根据IMN患者危险分层分为低危组(50例)、中危组(165例)和高危组(29例);采用Spearman相关分析NPAR与IMN患者危险分层的关系;根据预后结果将研究对象分为预后良好组(179例)和预后不良组(65例);采用受试者工作特征(ROC)曲线分析NPAR对IMN患者预后的预测价值;采用多因素Logistic逐步回归分析IMN患者预后的影响因素。结果中危组、高危组NPAR高于低危组,白蛋白(ALB)低于低危组(P<0.05);高危组NPAR高于中危组,ALB低于中危组(P<0.05)。NPAR与IMN患者危险分层呈正相关(r=0.608,P<0.001),ALB与IMN患者危险分层呈负相关(r=-0.514,P<0.001)。预后不良组NPAR显著高于预后良好组,ALB显著低于预后良好组(P<0.05)。ROC曲线分析显示,NPAR预测IMN患者预后的AUC为0.906,显著高于ALB预测的0.726(Z=12.533,P<0.001)。预后不良组IMN危险分层高危比例、高血压比例、糖尿病比例、肾小球硬化比例、血肌酐显著高于预后良好组(P<0.05)。多因素分析显示,IMN危险分层高危、糖尿病、肾小球硬化、NPAR≥2.50是IMN患者预后的独立危险因素(P<0.05)。结论NPAR与IMN患者危险分层密切相关,高NPAR是IMN患者预后的独立危险因素,对预测IMN患者预后有一定的临床价值。
Objective To explore the relationship between neutrophil percentage/albumin ratio(NPAR)and risk stratification and prognosis in patients with idiopathic membranous nephropathy(IMN).Methods A total of 244 IMN patients admitted to Fuyang People's Hospital from February 2017 to December 2022 were selected.According to the risk stratification of IMN patients,they were divided into low-risk group(n=50),medium-risk group(n=165)and high-risk group(n=29).Spearman correlation analysis was used to analyze the relationship between NPAR and IMN risk stratification.The study participants was further divided into a good prognosis group(n=179)and a poor prognosis group(n=65)based on prognosis.The predictive value of NPAR for IMN prognosis was analyzed using the receiver operating characteristic(ROC)curve.The influencing factors of IMN prognosis were explored by multivariate logistic stepwise regression.Results The NPAR of the medium-risk group and high-risk group was higher than that of the low-risk group,and the albumin(ALB)was lower than that of the low-risk group(P<0.05).The NPAR of the high-risk group was higher than that of the medium-risk group,and the ALB was lower than that of the medium-risk group(P<0.05).NPAR was positively correlated with the risk stratification of IMN patients(r=0.608,P<0.001),and ALB was negatively correlated with the risk stratification of IMN patients(r=-0.514,P<0.001).The NPAR of the poor prognosis group was significantly higher than that of the good prognosis group,and the ALB was significantly lower than that of the good prognosis group(P<0.05).ROC curve analysis showed that the AUC of NPAR for predicting the prognosis of IMN patients was 0.906,which was significantly higher than that of ALB at 0.726(Z=12.533,P<0.001).The proportion of high-risk IMN,hypertension,diabetes,glomerular sclerosis,and serum creatinine levels in the poor prognosis group was significantly higher than those in the good prognosis group(P<0.05).Multivariate analysis showed that high-risk IMN,diabetes,glomerular sclerosis,and NPAR≥2.50 were independent risk factors for the prognosis of IMN patients(P<0.05).Conclusion NPAR is closely related to IMN risk stratification,and high NPAR is an independent risk factor for IMN prognosis,which has certain clinical value in predicting IMN prognosis.
作者
徐丽
朱华夏
郭凯琦
黄兰兰
李小伟
XU Li;ZHU Huaxia;GUO Kaiqi;HUANG Lanlan;LI Xiaowei(Department of Nephrology,Fuyang People's Hospital,Fuyang,Anhui 236000,China)
出处
《转化医学杂志》
2025年第7期90-94,共5页
Translational Medicine Journal
基金
2024年度安徽省卫生健康科研项目(AHWJ2024Aa20394)。
关键词
中性粒细胞百分比/白蛋白比值
特发性膜性肾病
危险分层
预后
相关性
Neutrophil percentage/albumin ratio
Idiopathic membranous nephropathy
Risk stratification
Prognosis
Correlation
