基于真实世界的糖尿病肾脏疾病危险因素研究  

Real World Based Study on Risk Factors of Diabetic Kidney Disease

作　　者：杨金月 覃佐涛 王芳[1] 文思 朱国龙[1] 韩庆龙[1] YANG Jinyue;QIN Zuotao;WANG Fang;WEN Si;ZHU Guolong;HAN Qinglong(Three Gorges University Hospital of Traditional Chinese Medicine,Yichang Traditional Chinese Medicine Hospital,Yichang 443000,Hubei,China)

机构地区：[1]三峡大学中医医院,宜昌市中医医院,湖北宜昌443000

出　　处：《辽宁中医药大学学报》2022年第12期188-196,共9页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：湖北省宜昌市医疗卫生科研项目(A20-2-041)。

摘　　要：目的通过回顾性收集湖北省中医院177例既往诊断为2型糖尿病肾脏疾病的患者一般资料及实验室指标为研究资料,探讨糖尿病肾脏疾病(diabetic kidney disease,DKD)患者肾功能损伤的危险因素及中性粒细胞/淋巴细胞比值(NLR)与肾功能的相关性。方法使用SPSS 23.0分析软件,根据预估肾小球滤过率(estimated glomerular filtration rate,eGFR)<90 mL·min-1·1.73 m-2为发生肾损伤,分别将性别、年龄、2型糖尿病病程、身体质量指数(BMI)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、糖化血红蛋白(HbA1c)、NLR、血清总胆红素(STB)、血脂指标、尿微量白蛋白(Mau)、颈部动脉内中膜厚度(CIMT)等进行单因素回归分析其相关性;再将上述指标与eGFR进行多因素回归分析,得出糖尿病肾脏疾病的独立危险因素;通过受试者工作特征曲线(ROC曲线)确定独立危险因素的截断值,并根据其截断值分为两组,分析其作为临床指标与肾功能指标的相关性,通过其水平对DKD患者肾功能损伤做预测分析。结果糖尿病肾脏疾病患者年龄、2型糖尿病病程、NLR、同型半胱氨酸(Hcy)、CIMT与eGFR是负相关,FT3、FT4、STB与eGFR是正相关,年龄、NLR是DKD进程中的一个独立危险因素,且NLR与eGFR是负相关。结论糖尿病患者的肾脏损害与病程、Hcy、CIMT、甲状腺功能、STB有关,NLR比值作为潜在的炎症标志物,可用于早期识别发展为肾功能损伤的糖尿病患者,同时维持其比值在较低的水平有利于延缓DKD的进展。Objective To investigate the risk factors of renal function injury and the relationship between neutrophil/lymphocyte ratio(NLR)and renal function in patients with diabetic kidney disease by retrospectively collecting the general data and laboratory indicators of 177 patients previously diagnosed with type 2 diabetic renal disease in Hubei provincial hospital of traditional Chinese medicine.Methods SPSS23.0 analysis software was used to determine the occurrence of renal injury according to the estimated glomerular filtration rate(eGFR)<90 mL·min-1·1.73 m-2.Respectively to gender,age,course of type 2 diabetes,body mass index(BMI),three free iodine thyroid original FT3,FT4thyroid hormone free amino acid,thyroid stimulating hormone TSH,glycosylated hemoglobin(HbA1c),neutrophil,lymphocyte ratio(NLR),serum total bilirubin(STB),blood lipid index,urinary microalbuminuria(Mau)And cervical artery intima-media thickness(CIMT)were analyzed by univariate regression analysis.The independent risk factors of diabetic kidney disease were determined by multivariate regression analysis between these indexes and eGFR.The cut-off values of independent risk factors were determined by receiver operating characteristic curve(ROC curve)and divided into two groups according to the cut-off values.The correlation between clinical indicators and renal function indicators was analyzed,and the prediction of renal function injury in DKD patients was analyzed by its level.Results Age,course of type 2 diabetes,NLR,homocysteine(Hcy),CIMT were negatively correlated with eGFR,FT3,FT4,STB were positively correlated with eGFR,age and NLR were independent risk factors in DKD process,and NLR was negatively correlated with eGFR.Conclusion Kidney damage in diabetic patients is related to the course of disease,Hcy,CIMT,thyroid function and STB.NLR ratio,as a potential inflammatory marker,can be used for early identification of diabetic patients with renal impairment,while maintaining its ratio at a low level is conducive to delaying the progression of D

关 键 词：糖尿病肾脏疾病 中性粒细胞/淋巴细胞比值 真实世界 

分 类 号：R587.2[医药卫生—内分泌]