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比较中性粒细胞与淋巴细胞比值与传统炎性指标对2型糖尿病患者增强CT后造影剂肾病的预测价值

  

  1. 1.大连市中心医院 内分泌科,辽宁 大连 116033; 2. 大连市第三人民医院 心内一科,辽宁 大连 116033
  • 出版日期:2019-12-20 发布日期:2020-01-19
  • 通讯作者: 高政南, Email: gxl6406@sina.com

Comparison of  neutrophil to lymphocyte ratio  and  traditional  inflammatory markers in predicting  for contrastinduced nephropathy in patients with type 2 diabetes mellitus

  1. 1.Department of Endocrinology,  Dalian Municipal Central Hospital,   Dalian 116033,  China;
    2. Department of Cardiology,  Dalian Third People's Hospital,  Dalian 116033,  China
  • Online:2019-12-20 Published:2020-01-19
  • Contact: Correspondiong author: Gao Zhengnan, Email: gxl6406@sina.com

摘要: 目的  比较中性粒细胞与淋巴细胞比值(NLR)与尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)等传统炎性指标对糖尿病患者行增强CT后造影剂肾病(CIN)的预测价值。方法  选取行增强CT的2型糖尿病患者88例,检测行增强CT前及CT后6小时、24小时及48小时的血常规、血肌酐(SCr)、胱抑素(CysC)、高敏C反应蛋白(hsCRP)、尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)。根据尿MA/Cr结果,分为糖尿病肾病组及非糖尿病肾病组。根据CIN诊断标准,分为CIN组及正常组。分别比较两组间中性粒细胞淋巴细胞比值(NLR)与NGAL等指标的相关性,比较NLR与其它指标的预测价值。结果  所有患者CT后发生CIN的共有6例,发生率为6.8%,均发生在糖尿病肾病患者中。有糖尿病肾病组NLR、尿NGAL较非糖尿病组升高(P<0.05)。Pearson相关分析显示NLR与SCr显著正相关(r=0.785,P=0.012),NLR与尿NGAL亦明显正相关(r=0.764,P=0.018)。通过Logistics回归提示校正各种相关因素后,NLR仍是CIN发病的危险因素(P<0.05)。结论  糖尿病肾病患者更易发生造影剂肾病。糖尿病肾病患者NLR及尿NGAL明显升高。

关键词: 炎症, 糖尿病, 肾病, 造影剂

Abstract: Objective  To compare the neutrophil to lymphocyte ratio(NLR) and NGAL for  contrastinduced nephropathy(CIN) predictive value in patients with type 2 diabetes mellitus. Methods  A total of 88 patients with enhanced CT of type 2 diabetes mellitus were selected. The blood routine examination,  SCr,CysC, hsCRP and NGAL were measured before enhanced CT,  after 6 hours,  24 hours and  48 hours of enhanced CT. According to the results of  tourine MA/Cr, the patients were divided into two groups, diabetic nephropathy(DN) and non DN group. Based on the diagnosis of CIN, the 88 patients were divided into CIN group(n=82) and normal group(n=6)  to analyze the association of  NLR  and NGAL,  and to compare the predictive value of NLR and other indexes.Results  Totally six patients (6.8%) with DN suffered from CIN after enhanced CT. NLR and NGAL were higher in patients with DN than patients without DN(P<0.05). Pearson correlation analysis showed that NLR was positively associated with SCr(r=0.785,P=0.012) and NGAL (r=0.764,P=0.018). After adjustment for some factors,  according to the logistics regression, NLR  was still a  risk factor of CIN(P<0.05).Conclusion  DN patients are more likely to have CIN.  NLR  and urine NGAL were higher in patients with DN.

Key words: inflammation;diabetes mellitus;nephrosis, contrast media