外周血中性粒细胞/淋巴细胞比值与2型糖尿病肾病患者肾损伤相关性及早期诊断效能研究

Research of Correlation between Peripheral Blood Neutrophil/Lymphocyte Ratio and Renal Injury in Patients with Type 2 Diabetic Nephropathy and Its Early Diagnosis Efficiency

目的:探究外周血中性粒细胞/淋巴细胞比值与2型糖尿病肾病(T2DN)患者肾损伤相关性及早期诊断效能。方法:研究对象选取于2021年6月-2022年3月在赣州市赣县区人民医院内分泌科住院的2型糖尿病(type 2 diabetes mellitus,T2DM)患者70例及T2DN患者130例。将T2DM患者纳入C组,根据尿白蛋白/肌酐比值(urine albumin creatine ratio,UACR)水平将T2DN患者分为A组、B组,各65例,同期在本院体检健康者105例作为D组。观察四组中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、肌酐(creatinine,Cr)、血尿素氮(blood urea nitrogen,BUN)、尿酸(uric acid,UA)、胱抑素C(cystatin C,Cys C)、同型半胱氨酸(homocysteine,Hcy)表达情况,并分析NLR与其他指标的相关性及对T2DN的早期诊断效能。结果:各组NLR、HbA1c、Hcy比较,差异均有统计学意义(P<0.05),且A组、B组、C组NLR、HbA1c、Hcy、Cr、BUN、UA显著高于D组,A组、B组Cys C、Hcy显著高于C组,A组NLR显著高于B组、C组,差异均有统计学意义(P<0.05)。各组Cr、BUN、UA比较,差异均有统计学意义(P<0.05),且A组、B组Cr、BUN、UA显著高于C组,A组Cr、BUN、UA显著高于B组,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,NLR与CR、BUN、UA呈强相关,与Cys C有一定相关性(P<0.05)。ROC曲线显示,当NLR取值为2.625时其取得最大曲线下面积(AUC),敏感度=88.50%,特异度=84.30%,AUC=0.590。结论:T2DM患者NLR呈现升高趋势,合并DN患者,随着其病情进展NLR表达持续升高,且与肾功能相关指标呈现相关性,NLR在T2DN患者辅助诊断及预后中表现出一定价值。

Objective:To explore the correlation between peripheral blood neutrophil/lymphocyte ratio and renal injury in patients with type 2 diabetic nephropathy(T2DN)and its early diagnosis efficiency.Method:The study subjects were selected from 70 patients with type 2 diabetes mellitus(T2DM)and 130 patients with T2DN who were hospitalized in the Endocrinology Department of Ganxian District People's Hospital,Ganzhou City from June 2021 to March 2022.Patients with T2DM were included in group C.According to the urine albumin creatine ratio(UACR),patients with T2DN were divided into group A and group B,with 65 cases in each group,and 105 healthy people in our hospital served as group D in the same period.The expression situation of neutrophil/lymphocyte ratio(NLR),glycosylated hemoglobin(HbA1c),creatinine(Cr),blood urea nitrogen(BUN),uric acid(UA),cystatin C(Cys C)and homocysteine(Hcy)were observe in the four groups,and the correlation between NLR and other indexes and its early diagnosis efficiency of T2DN were analyzed.Result:There were significant differences in NLR,HbA1c and Hcy among all groups(P<0.05),and the NLR,HbA1c,Hcy,Cr,BUN,and UA in group A,B and C were significantly higher than those in group D,Cys C and Hcy in group A and B were significantly higher than those in group C,and the NLR in group A was significantly higher than that in group B and C,the differences were statistically significant(P<0.05).There were significant differences in Cr,BUN and UA among all groups(P<0.05),and Cr,BUN and UA in group A and B were significantly higher than those in group C,and Cr,BUN and UA in group A were significantly higher than those in group B(P<0.05).Pearson correlation analysis showed that NLR had a strong correlation with Cr,BUN,and UA,and a certain correlation with Cys C(P<0.05).The ROC curve shows that when NLR 2.625,the maximum area under the curve obtained,with sensitivity=88.50%,specificity=84.30%and AUC=0.590.Conclusion:NLR in patients with T2DM showed an increasing trend,and the expression of NLR increased continuously with the progress of the disease in patients with T2DN,and it shows a correlation with renal function related indicators.NLR shows certain value in the auxiliary diagnosis and prognosis of patients with T2DN.