中性粒细胞与淋巴细胞比值、血肌酐、尿免疫球蛋白G及联合检测对老年2型糖尿病肾病患者的诊断价值

Diagnostic value of neutrophil-tolymphocyte ratio,serum creatinine,urine immunoglobulin G and combined detection in elderly patients with type 2 diabetic nephropathy

目的探讨中性粒细胞与淋巴细胞比值(NLR)、血肌酐(Cr)、尿免疫球蛋白G(uIGG)及联合检测对老年2型糖尿病肾病患者的诊断价值。方法选取2022年1月至2023年6月湖州市南浔区人民医院临床确诊为2型糖尿病(T2DM)的老年患者223例,分为糖尿病肾病(DN)组和T2DM组。比较两组患者一般资料、血常规、超敏C反应蛋白(hs-CRP)、生化、尿肾功能敏感六项指标;采用Pearson相关性分析NLR与各指标的相关性;使用logistic回归分析DN的独立危险因素;应用受试者工作特征(ROC)曲线评价NLR、Cr、uIGG单一检测和联合检测的诊断效能。结果DN组视网膜病变患病率、病程、同型半胱氨酸(HCY)、尿素氮(BUN)、Cr、尿酸(UA)、NLR、hs-CRP、uIGG、尿α_(1)-微球蛋白(uα_(1)-MG)水平明显高于T2DM组,差异均有统计学意义(χ^(2)=5.38,t分别=-2.52、-3.41、-4.81、-6.18、-4.02、-5.13,Z分别=-2.21、-2.56、-2.13,P均<0.05)。Pearson相关性分析显示,NLR与hs-CRP、HCY、BUN、Cr、UA呈正相关(r分别=0.33、0.30、0.36、0.45、0.27,P均<0.05)。logistic回归模型分析显示,合并视网膜病变、病程长、高Cr、高NLR、高uIGG水平是DN的独立危险因素(OR分别=13.22、1.08、1.03、1.66、1.01,P均<0.05)。将NLR、Cr、uIGG作为检验诊断指标,NLR+Cr联合检测时,其曲线下面积最大(0.82),灵敏度为88.46%,特异度为75.63%。结论NLR和Cr联合检测能明显提高DN的诊断能力,为临床早期诊断提供依据。

Objective To investigate the diagnostic value of neutrophil-lymphocyte ratio,serum creatinine,urine immunoglobulin G and combined detection in elderly patients with type 2 diabetic nephropathy.Methods A total of 223 elderly patients clinically diagnosed with type 2 diabetes mellitus(T2DM)in Nanxun District People's Hospital of Huzhou City from January 2022 to June 2023 were selected and divided into diabetic nephropathy(DN)group and simple T2DM group.The general data,blood routine,hypersensitive C-reactive protein(hs-CRP),biochemistry and urine and kidney function were compared between the two groups.Pearson correlation was used to analyze the correlation between neutrophil-lymphocyte ratio(NLR)and various indicators.Logistic regression analysis was used to analyze the independent risk factors of DN.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of single and combined detection.Results The morbidity of retinopathy,course of disease,homocysteine(HCY),urea nitrogen(BUN),creatinine(Cr),uric acid(UA),NLR,hs-CRP,urine immunoglobulin G(uIGG),and urine α_(1)-microglobulin(uα_(1)-MG)levels were significantly higher than those in the T2DM group,and the differences were statistically significant(χ^(2)=5.38,t=-2.52,-3.41,-4.81,-6.18,-4.02,-5.13,Z=-2.21,-2.56,-2.13,P<0.05).Pearson correlation analysis showed that NLR was positively correlated with hs-CRP,HCY,BUN,Cr,and UA(r=0.33,0.30,0.36,0.45,0.27,P<0.05).Logistic regression analysis showed that retinopathy,longer course of disease,higher Cr,NLR,and uIGG levels were independent risk factors for DN(OR=13.22,1.08,1.03,1.66,1.01,P<0.05).The area under the curve of NLR and Cr combined detection was the largest(0.82),the sensitivity was 88.46%,and the specificity was 75.63%.Conclusion The combined detection of NLR and Cr can significantly improve the diagnostic ability of DN and provide a basis for early clinical diagnosis.