Effect Of Parathyroidectomy On The Neutrophil-to-lymphocyte Ratio And The Platelet-to-lymphocyte Ratio In Patients With Secondary Hyperparathyroidism

Objective1.This study sought to investigate the changes of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in patients with secondary hyperparathyroidism(SHPT)after parathyroidectomy(PTX).2.Analyze the correlation between NLR and PLR and blood biochemical indicators of SHPT patients.MethodsTo selecte 151 maintenance dialysis patients who received PTX treatmentin the Department of Nephrology,Second Affiliated Hospital of Anhui Medical University from January 2013 to January 2019.Collect the patients’ preoperative general information and laboratory indicators,calculate the calcium-phosphorus product,NLR value,PLR value.Analyze the correlation between preoperative NLR,PLR and preoperative SHPT patients’ blood biochemical indicators.According to the level of i PTH after surgery,the patients were divided into the successful group and the group with persistent SHPT or recurrent SHPT,to compare the changes of NLR(?NLR),PLR(?PLR)and other indicators after surgery between the two groups.And the correlation between the changes of the patients’ blood biochemical indicators.Results1.Of the 139 SHPT subjects who meet the inclusion criteria in this study,including94 men(67.6%),45 women(32.4%),age(46.0±8.0)years,dialysis time 7.0(6.0,9.0)years,follow-up time 2.0(1.0,3.0)years,138 cases of hemodialysis(99.3%),1 case of peritoneal dialysis(0.7%),6 cases underwent subtotal parathyroidectomy(4.3%),24 cases underwent total parathyroidectomy(17.3%),109 cases underwent total parathyroidectomy and autologous transplantation(78.4%).2.Correlation analysis of preoperative NLR,PLR and indicators: preoperative NLR was positively correlated with white blood cell count,hs-CRP,serum phosphorus,calcium and phosphorus product,and negatively correlated with lymphocyte count(P<0.05),no correlation with i PTH,etc.(P>0.05).Preoperative PLR was positively correlated with serum phosphorus,calcium-phosphate product,platelet count,negatively correlated with serum iron and hemoglobin(P<0.05),and had no correlation with hs-CRP,etc.(P>0.05).3.Changes in indicators of the two groups of patients before and after surgery: In the successful surgery group,serum calcium,serum phosphorus,NLR,PLR,i PTH decreased significantly,and hemoglobin,red blood cell count,and lymphocyte count were significantly higher than that before surgery(P<0.05).In the persistent SHPT or recurrent SHPT group,postoperative serum calcium and i PTH decreased compared with preoperatively(P<0.05),while the comparison of NLR,PLR,hemoglobin and other indicators before and after surgery showed no significant difference(P>0.05).Changes in indicators of the two groups of patients before and after surgery: In the successful surgery group,serum calcium,serum phosphorus,NLR,PLR,i PTH decreased significantly,and hemoglobin,red blood cell count,and lymphocyte count were significantly higher than that before surgery(P<0.05).In the persistent SHPT or recurrent SHPT group,postoperative serum calcium and i PTH decreased compared with preoperatively(P<0.05),while the comparison of NLR,PLR,hemoglobin and other indicators before and after surgery showed no significant difference(P>0.05).4.Correlation analysis of ?NLR,?PLR and each indicator variation: in the successful surgery group,?NLR was positively correlated with serum phosphorus and calcium-phosphorus product variation(P<0.05).There was no correlation with i PTH,and serum calcium variation(P>0.05).?PLR was negatively correlated with hemoglobin variation,and positively correlated with serum phosphorus,calcium-phosphorus product,and i PTH variation(P<0.05),but had no correlation with serum calcium variation(P>0.05).Conclusions1.Compared with PLR,NLR as an inflammatory marker can better reflect the inflammatory state of SHPT patients.2.NLR and PLR were correlated with bone mineral metabolism indicators and hemoglobin.3.Successful PTX can reduce NLR and PLR,and through the modulatory effects of parathyroidectomy on systemic inflammation may directly or indirectly improve the symptoms of anemia and mineral bone metabolism disorders in patients with SHPT in some extentand.