炎症评分NLR和PLR对糖尿病肾病患者的诊断价值及相关性研究

Diagnostic Value and Relevance of Inflammation Score for NLR and PLR in Patients with Diabetic Nephropathy

目的评估中性粒细胞-淋巴细胞比值(NLR)和血小板-淋巴细胞比值(PLR)诊断肾穿刺确诊糖尿病肾病(DN)的有效性及与DN的关系。方法选取125例经肾活检确诊的DN患者和32例2型糖尿病(T2DM)患者作为研究对象。收集患者的一般资料及实验室指标,计算各组NLR和PLR。分析NLR、PLR与DN肾功能、蛋白尿及DN病理分级的相关性。采用受试者工作特征(ROC)曲线评估NLR、PLR诊断DN的有效性。依据DN的病理分级,分析NLR和PLR和DN严重程度的关系。多因素logistic回归分析NLR、PLR与DN的关系。结果与T2DM组相比,DN患者的NLR、PLR较高(P<0.05)。相关性分析显示,NLR和PLR与尿白蛋白与肌酐比值(uACR)、尿素呈正相关(P<0.05),与估计肾小球滤过率(eGFR)、白蛋白和血红蛋白呈负相关(P<0.05)。ROC曲线分析显示,NLR的曲线下面积(AUC)高于PLR,但两者合并诊断的AUC无明显变化。在亚组分析中,NLR和PLR随着DN的病理分级增加而增加。多因素logistic回归分析显示,NLR和PLR升高是DN的独立危险因素(P<0.05)。结论与T2DM相比,DN患者的NLR和PLR较高,随着DN的进展而逐渐增加。NLR和PLR是DN的独立危险因素。

Objective To evaluate the validity of neutrophil-to-lymphocyte ratio(NLR)and platelets-to-lymphocyte ratio(PLR)in diagnosing diabetic nephropathy(DN)confirmed by renal puncture and the relationship with DN.Methods A total of 125 patients with DN confirmed by renal biopsy and 32 patients with type 2 diabetes mellitus(T2DM)were selected as study objects.General data and laboratory indices of the patients were collected,and NLR and PLR values were calculated for each group.The correlation between NLR and PLR and DN renal function,proteinuria and DN pathological grading was analyzed.Receiver operating characteristics(ROC)curve analysis was performed to assess the validity of NLR and PLR in diagnosing DN.The relationship between NLR and PLR and DN severity was analyzed according to the pathological classification of DN.Multivariate logistic regression analysis was performed to analyze the relationship between NLR,PLR and diabetic nephropathy.Results Compared with the T2DM group,the NLR and PLR of DN patients were higher(P<0.05).Correlation analysis showed that NLR and PLR were positively correlated with urine albumin-creatinine ratio(uACR)and urea(P<0.05),and negatively correlated with estimated glomerular filtration rate(eGFR),albumin(ALB)and hemoglobin(HB)(P<0.05).ROC curve analysis demonstrated that the area under the curve(AUC)of NLR was higher than that of PLR,but there was no statistically significant change in AUC for the combined diagnosis of both.NLR and PLR increased with increasing pathological class of DN in subgroup analysis.Multivariate logistic regression analysis showed that increased NLR and PLR were independent risk factors for DN(P<0.05).Conclusion NLR and PLR are higher in patients with DN compared to T2DM and be increasingly higher with the progression of DN.NLR and PLR are independent risk factors for DN.