中性粒细胞/淋巴细胞比值、血清胱抑素C在糖尿病肾病早期诊断及肾损伤程度评估中的应用价值

Application Value of Neutrophil/Lymphocyte Ratio and Serum Cystatin C in Early Diagnosis of Diabetic Nephropathy and Assessment of the Degree of Kidney Injury

目的:探讨中性粒细胞/淋巴细胞比值(NLR)、血清胱抑素C(CysC)在糖尿病肾病(DN)早期诊断及肾损伤程度评估中的应用价值。方法:选取2021年2月—2024年2月榆林市府谷县人民医院收治的DN患者80例作为DN组,另选取同期本院就诊的单纯2型糖尿病患者80例为对照组。比较两组血清CysC、NLR水平差异,采用受试者工作特征(ROC)曲线分析上述指标对DN的诊断价值。根据尿白蛋白排泄率将DN组分为微量白蛋白尿DN组(微量组,n=49)、大量白蛋白尿DN组(大量组,n=31),比较两组血清CysC、NLR水平及肾功能指标,Pearson相关性分析血清CysC、NLR与肾功能指标的关系。结果:DN组血清CysC、NLR水平均高于对照组(P<0.001)。ROC曲线结果显示,血清CysC、NLR及联合检测DN的曲线下面积分别为0.752、0.754、0.853。微量组血清CysC、NLR、血尿酸、血清肌酐、血尿素氮水平均低于大量组,肾小球滤过率高于大量组(P<0.05)。Pearson相关性分析显示,CysC、NLR与血尿酸、血清肌酐、血尿素氮呈正相关,与肾小球滤过率呈负相关(P<0.05)。结论:NLR、CysC在DN患者中异常升高,通过检测相关指标可为早期DN诊断及肾损伤程度评估提供依据。

Objective:To investigate the application value of neutrophil/lymphocyte ratio(NLR)and serum cystatin C(CysC)in the early diagnosis of diabetic nephropathy(DN)and the assessment of the degree of renal injury.Methods:Eighty cases of DN patients admitted to Yulin Fugu County People's Hospital from February 2021 to February 2024 were selected as the DN group,and eighty cases of patients with simple type 2 diabetes mellitus attending our hospital during the same period were selected as the control group.The differences in serum CysC and NLR levels between the two groups were compared,and the diagnostic value of the above indexes for DN was analyzed by using the subject's work characteristics(ROC)curve.According to the urinary albumin excretion rate,the DN group was divided into microalbuminuria DN group(micro group,n=49)and macroalbuminuria DN group(macro group,n=31),and the serum CysC and NLR levels and renal function indexes of the two groups were compared,and the relationship between serum CysC and NLR and renal function indexes was analyzed by Pearson correlation.Results:The serum CysC and NLR levels in the DN group were higher than those in the control group(P<0.001).The results of the ROC curve showed that the areas under the curve of serum CysC,NLR and the combined detection of DN were 0.752,0.754 and 0.853,respectively.The levels of serum CysC,NLR,blood uric acid,serum creatinine,and blood urea nitrogen in the micro group were lower than those in the macro group,and the glomerular filtration rate was higher than that in the macro group(P<0.05).Pearson correlation analysis showed that CysC and NLR were positively correlated with blood uric acid,serum creatinine,and blood urea nitrogen,and negatively correlated with glomerular filtration rate(P<0.05).Conclusion:NLR and CysC are abnormally elevated in DN patients,and the detection of related indexes can provide a basis for early DN diagnosis and assessment of the degree of renal injury.