血NLR及Cysc评估早期糖尿病肾病的预测价值研究

Study on predictive value of blood NLR and Cysc in evaluating early diabetic nephropathy

目的 探讨中性粒细胞-淋巴细胞比值(NLR)、血胱抑素C(CysC)在早期糖尿病肾病中的评估及预测价值。方法 选取2019年3月—2021年3月柘城县人民医院收治的2型糖尿病患者150例,按中国2型糖尿病防治指南(2017年版)标准分为单纯糖尿病组(DM)40例、早期糖尿病肾病组(EDN)55例以及临床糖尿病肾病组(DN)55例,另选取同期在本院行健康体检的健康体检者30例作为对照组,进行血NLR、CysC检测,并对其结果进行分析。结果 在NLR、CysC水平比较上,DN组>EDN组>DM组>对照组,差异有统计学意义(P<0.05)。血NLR、CysC间呈正相关(r=0.275,P=0.000<0.05)。NLR、CysC联合诊断糖尿病肾病的灵敏度、特异度分别为78.00%和73.33%,AUC为0.818,其诊断效能优于NLR、CysC单一指标检测(Z=0.032、0.001,P<0.05)。结论 糖尿病肾病患者NLR、CysC水平显著升高,二者联合检测有助于提高早期糖尿病肾病患者诊断的敏感性。

Objective To investigate the value of whole blood neutrophil-lymphocyte ratio(NLR) and blood cystatin C(CysC) in the evaluation and prediction of early diabetic nephropathy. Methods A total of 150 patients with type 2 diabetes admitted to the First Affiliated Hospital of Xinxiang Medical University from March 2019 to March 2021 were divided into simple diabetes group(DM)(n=40), early diabetic nephropathy group(EDN)(n=55) and clinical diabetic nephropathy group(DN)(n=55), according to Chinese Guidelines for the Prevention and Treatment of Type 2 diabetes(2017 edition). In addition, 30 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group, and blood NLR and CysC were detected, and the results were analyzed. Results The level of NLR and CysC in DN group > EDN group > DM group > control group(P<0.05). There was a positive correlation between blood NLR and CysC(r=0.275, P=0.000< 0.05). The sensitivity and specificity of combined NLR and CysC in the diagnosis of diabetic nephropathy were 78.00% and 73.33%, respectively, and the AUC was 0.818, which was better than the single index detection of NLR and CysC(Z=0.032, 0.001, P<0.05). Conclusion The levels of NLR and CysC in diabetic nephropathy patients are significantly increased, and the combined detection of NLR and CysC can improve the sensitivity of early diagnosis of diabetic nephropathy patients.