糖尿病肾病肾功能不全的影响因素及肿瘤坏死因子-α对其预测价值  

Influence Factors of Diabetic Nephropathy Renal Insufficiency and the Predictive Value of Tumor Necrosis Factor-α

作　　者：李冬梅[1] 毛盛 张兴华 LI Dongmei;MAO Sheng;ZHANG Xinghua(The Fifth People's Hospital of Datong,Datong 037000,China;不详)

机构地区：[1]大同市第五人民医院,山西大同037000

出　　处：《中外医学研究》2023年第1期167-170,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析糖尿病肾病(DN)肾功能不全影响因素及肿瘤坏死因子-α(TNF-α)对DN肾功能不全预测价值。方法:回顾性分析2022年1-5月大同市第五人民医院住院治疗的DN患者90例,根据肾小球滤过率(e-GFR)是否<60 mL/(min·1.73 m^(2)),将所有DN患者分为肾功能不全组(41例)和非肾功能不全组(49例),比较两组临床资料,将差异有统计学意义的指标纳入二元logistic回归分析,并分析TNF-α对肾功能不全预测价值。结果:肾功能不全组病程、TNF-α、中性粒细胞/淋巴细胞(NLR)、C反应蛋白(CRP)均明显高于非肾功能不全组,e-GFR、白蛋白(ALB)均明显低于非肾功能不全患者(P<0.05)。二元logistic回归分析显示,病程、TNF-α、NLR均为DN患者肾功能不全独立影响因素,ALB为保护性因素(OR=1.398、1.066、16.945、0.765,P<0.05)。NLR与CRP,HbA1c与FPG呈正相关,BUN与ALB呈负相关(r=0.322、0.201、-0.279),差异有统计学意义(P<0.05)。TNF-α预测DN肾功能不全AUC为0.714(95%CI:0.609,0.819),最佳截断值为102.50 pg/mL,预测敏感度为65.85%,特异度为73.47%。结论:病程、TNF-α、NLR、ALB为DN肾功能不全独立影响因素,且TNF-α对其有一定预测价值。Objective:To analyze influence factors of diabetic nephropathy renal insufficiency and the predictive value of tumor necrosis factor-α(TNF-α).Method:A total of 90 patients with DN hospitalized in the Fifth People’s Hospital of Datong from January to May 2022 were retrospectively analyzed.According to whether the glomerular filtration rate(e-GFR)was less than 60 mL/(min·1.73 m^(2)),all patients with DN were divided into renal insufficiency group(41 cases)and non renal insufficiency group(49 cases),the differences of clinical data between the two groups were compared.The potential indicators were included in the binary logistic regression analysis,and TNF-αwas analyzed the predictive value for renal insufficiency.Result:The course of disease,TNF-α,neutrophil/lymphocyte(NLR)and C-reactive protein(CRP)in renal insufficiency group were significantly higher than those in non renal insufficiency group,while e-GFR and albumin(ALB)were significantly lower than those in non renal insufficiency patients(P<0.05).Binary logistic regression analysis showed that the course of disease,TNF-αand NLR were independent influencing factors of renal insufficiency in DN patients,ALB was a protective factor(OR=1.398,1.066,16.945,0.765,P<0.05).NLR and CRP,HbA1c and FPG were positively correlated,while BUN was negatively correlated with ALB(r=0.322,0.201,-0.279),the differences were statistically significant(P<0.05).The AUC of renal insufficiency predicted by TNF-αwas 0.714(95%CI:0.609,0.819),the optimal cut-off value,predictive sensitivity and specificity were 102.50 pg/mL,65.85%and 73.47%respectively.Conclusion:Disease course,TNF-α,NLR,ALB were independent factors of renal insufficiency in DN,and TNF-αhas a certain predictive value for renal insufficiency.

关 键 词：2型糖尿病 糖尿病肾病 肾功能不全 肿瘤坏死因子-Α 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]