血清CHI3L1、NLR联合检测对糖尿病肾病的诊断价值  

The value of combined detection of serum CHI3L1 and NLR in diagnosis of diabetes nephropathy

作　　者：崔博坤 刘静芹[1] 冯然[1] 王鹏[2] 徐广超 刘继朋 CUI Bokun;LIU Jingqin;FENG Ran;WANG Peng;XU Guangchao;LIU Jipeng(Department of Endocrinology;Hemodialysis Room;Department of Clinical Laboratory,the First Hospital of Baoding,Baoding,Hebei 071000,China)

机构地区：[1]河北省保定市第一医院内分泌科,河北保定071000 [2]河北省保定市第一医院血液透析室,河北保定071000 [3]河北省保定市第一医院检验科,河北保定071000

出　　处：《检验医学与临床》2024年第10期1401-1405,共5页Laboratory Medicine and Clinic

基　　金：河北省医学科学研究课题计划项目(20191230)。

摘　　要：目的探讨血清壳多糖酶3样蛋白1(CHI3L1)、中性粒细胞/淋巴细胞比值(NLR)联合检测对糖尿病肾病(DN)的诊断价值。方法选取2022年2月至2023年2月该院收治的88例DN患者作为DN组,另外选取同期接诊的81例单纯糖尿病患者作为糖尿病组,88例同期于该院体检的健康者作为对照组。采用Pearson相关分析DN患者血清CHI3L1水平与NLR的相关性;采用Logistic回归分析CHI3L1、NLR对DN发生的影响;采用受试者工作特征(ROC)曲线分析血清CHI3L1、NLR对DN的诊断价值。结果3组糖化血红蛋白(HbA1c)、肾小球滤过率(GFR)、尿清蛋白/肌酐比值(UACR)、C反应蛋白(CRP)、降钙素原(PCT)及红细胞沉降率(ESR)比较,差异均有统计学意义(P<0.05)。DN组血清CHI3L1、NLR水平明显高于糖尿病组及对照组,且糖尿病组高于对照组,差异均有统计学意义(P<0.05)。DN患者血清CHI3L1水平与NLR呈正相关(r=0.853,P<0.05)。Logistic回归分析显示,NLR、CHI3L1水平升高为DN发生的危险因素(P<0.05)。ROC曲线分析结果显示,血清CHI3L1、NLR单独诊断DN的曲线下面积(AUC)分别为0.683、0.712,二者联合诊断DN的AUC为0.809,二者联合诊断的AUC明显大于血清CHI3L1、NLR单独诊断的AUC(Z=3.306,P<0.001;Z=3.623,P<0.001)。结论血清CHI3L1水平、NLR与DN发生密切相关,二者联合对DN具有较高的诊断价值。Objective To explore the value of combined detection of serum chitosanase 3-like protein 1(CHI3L1)and neutrophil to lymphocyte ratio(NLR)in the diagnosis of diabetes nephropathy(DN).Methods A total of 88 DN patients admitted to the First Hospital of Baoding from February 2022 to February 2023 were collected as the DN group,in addition,81 patients with simple diabetes who were treated at the same time were collected as the diabetes group,and 88 healthy people who were examined at this hospital at the same time were regarded as the control group.Pearson correlation was applied to analyze the correlation between serum CHI3L1 and NLR in DN patients.Logistic regression was used to analyze the effects of CHI3L1 and NLR levels on the occurrence of DN.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum CHI3L1 and NLR levels for DN.Results There were significant differences on glycated hemoglobin A1c(HbA1c),glomerular filtration rate(GFR),urinary albumin/creatinine ratio(UACR),C-reactive protein(CRP),procalcitonin(PCT)and blood sedimentation rate(ESR)among the three groups(P<0.05).The levels of serum CHI3L1 and NLR in the DN group were significantly higher than those in the diabetes group and the control group,and those in the diabetes group were higher than those in the control group,the differences were statistically significant(P<0.05).Serum CHI3L1 level correlated positively with NLR in DN patients(r=0.853,P<0.05).Logistic regression analysis showed that NLR and CHI3L1 were risk factors for DN(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum CHI3L1 and NLR in the diagnosis of DN were 0.683 and 0.712 respectively,and the AUC of combined detection of the two indicators in the diagnosis of DN was 0.809.The AUC of the combined detection of the two indicators was significantly higher than that of serum CHI3L1 or NLR alone(Z=3.306,P<0.001;Z=3.623,P<0.001).Conclusion The serum levels of CHI3L1 and NLR relate closely to the occurrence of DN,and their combin

关 键 词：糖尿病肾病 中性粒细胞/淋巴细胞比值 壳多糖酶3样蛋白1 诊断价值 糖化血红蛋白 

分 类 号：R587.2[医药卫生—内分泌]