中性粒细胞与淋巴细胞的比值与MAL、ACR联合检测2型糖尿病肾病患者的临床意义

Clinical Significance of Combined Detection of Neutrophil/Lymphocyte Ratio,MAL and ACR in Type 2 Diabetic Patients with Nephropathy

目的通过研究中性粒细胞与淋巴细胞的比值(NLR)在2型糖尿病肾病(T2DN)中的变化,探讨NLR与T2DN之间的关系。方法将研究对象分为健康对照组25例,无尿蛋白的单纯2型糖尿病组33例(T2DM组),2型糖尿病并肾病组53例(T2DN组),根据肾脏损害程度的Mogensen分级标准,将T2DN组分为2个亚组:微量白蛋白尿组(N1)和大量白蛋白尿组(N2),检测各组的NLR、24h尿微量蛋白(MAL)、尿微量蛋白与肌酐比值(ACR)。结果 T2DM组和T2DN组NLR水平明显高于健康组(P<0.001),T2DN组NLR水平明显高于T2DM组(P<0.05)。N2组患者NLR水平和N1组无差异(P>0.05)。N1组NLR与MAL及ACR之间不存在相关关系;N2组NLR与MAL之间存在相关关系,相关系数为0.733,NLR与ACR之间存在相关关系,相关系数为0.709。结论 NLR、MAL、ACR可作为诊断2型糖尿病肾病的较敏感指标,对判断2型糖尿病肾病大量尿蛋白期的肾损害程度有重要意义。

Objective To investigate the change in neutrophil/lymphocyte ratio(NLR)in patients with type 2 diabetic nephropathy(T2 DN),and to explore the relationship between NLR and T2 DN.Methods A total 111 patients were divided into healthy control group(n=25),type 2 diabetes mellitus(T2 DM)group(n=33)and T2 DN group(n=53).According to the Mogensen classification,T2 DN group was further divided into two subgroups:27 cases of microalbuminuria(N1 group)and 26 cases of macroalbuminuria(N2 group).The NLR,24-hour urinary microalbumin(MAL)and albumin/creatinine ratio(ACR)were detected in all groups.Results The NLR in T2 DN group or T2 DM group was higher than that in healthy group(P<0.001),and that in T2 DN group were higher than that in T2 DM group(P<0.05).There was no significant difference in NLR between N1 group and N2 group(P>0.05).The NLR was not correlated with MAL and ACR in N1 group.In N2 group,there was a highly positive correlation between NLR and MAL(r=0.733),as well as between NLR and ACR(r=0.709).Conclusion The NLR,MAL and ACR can be used as the sensitive indexes for diagnosis of T2 DN,which have important significance for judging the degree of kidney damage in T2 DN patients with macroalbuminuria.