中性粒细胞/淋巴细胞比值及血清肿瘤坏死因子α与2型糖尿病患者下肢动脉病变的相关性研究  

Relationship between neutrophil/lymphocyte ratio and serum TNF-α with lower extremity arterial disease in type 2 diabetic patients

作　　者：李婉媚[1] 许雯[2] 姚斌[2] 孙燕[1] 朱常青[1] 黄懿文 LI Wanmei;XU Wen;YAO Bin(Department of Endocrinology,Guangzhou 12Th People’s Hospital,Guangzhou 510620,China)

机构地区：[1]广州市第十二人民医院内分泌科,510620 [2]中山大学附属第三医院内分泌与代谢病科

出　　处：《中国糖尿病杂志》2020年第7期481-485,共5页Chinese Journal of Diabetes

基　　金：国家自然科学基金(81770821);国家重点研发计划(2016YFC1304800)。

摘　　要：目的观察T2DM合并下肢动脉病变(LEAD)患者中性粒细胞/淋巴细胞比值(NLR)及血清TNF-α的变化,探讨其与下肢动脉血管狭窄程度的相关性。方法选取2017年1月至2019年1月于广州市第十二人民医院接受下肢动脉彩超检查并诊断为LEAD的T2DM住院患者348例(LEAD组),另选取同期彩超检查下肢动脉正常的T2DM患者120例为对照(Con)组。LEAD组根据下肢动脉狭窄程度分为<30%的轻度亚组188例、30%~75%的中度亚组106例和≥75%的重度亚组54例。分析NLR、TNF-α变化与下肢动脉狭窄程度的关系。结果LEAD组NLR、TNF-α水平高于Con组(P<0.05)。随着狭窄程度加重,NLR、TNF-α水平逐渐升高(P<0.05);Logistic回归分析显示,NLR(OR 1.072,95%CI 1.020~1.127)、TNF-α(OR 1.027,95%CI 1.022~1.032)是LEAD重度狭窄的危险因素。结论T2DM合并LEAD患者NLR和TNF-α水平升高,提示下肢动脉狭窄进展对病情严重程度的评估具有重要意义。Objective To observe the changes of neutrophil/lymphocyte ratio(NLR)and serum tumor necrosis factorα(TNF-α)levels in patients with type 2 diabetes mellitus(T2DM)complicated with lower extremity arterial disease(LEAD),and to explore the correlation between these two indicators and the degree of LEAD.Methods A total of 348 T2DM patients who underwent lower extremity arterial color Doppler ultrasonography and were diagnosed with LEAD from January 2017 to January 2019 were enrolled.According to the degree of LEAD,the selected patients were divided into mild stenosis group(stenosis degree<30%,n=188),moderate stenosis group(30%~75%stenosis degree,n=106),severe stenosis group(stenosis degree≥75%,n=54).120 T2DM patients with normal lower extremity color Doppler ultrasound were set as control group(Con).The relationship between changes in NLR and TNF-αlevels and the degree of LEAD was analyzed.Results The levels of NLR and TNF-αwere significantly higher in T2DM patients complicated with LEAD than those in Con group(P<0.05).The levels of NLR and TNF-αin patients with LEAD increased gradually with the severity of stenosis(P<0.05).NLR(OR 1.072,95%CI1.020~1.127)and TNF-α(OR 1.027,95%CI 1.022~1.032)levels were independent risk factors for the severe stenosis of LEAD.Conclusion The levels of NLR and TNF-αare increased with the severity of LEAD in T2DM patients,which is help to alert the severity of the disease.

关 键 词：下肢动脉病变 糖尿病 2型 中性粒细胞/淋巴细胞比值 肿瘤坏死因子Α 

分 类 号：R587.2[医药卫生—内分泌] R543.5[医药卫生—内科学]