目的:探讨肾小球补体C1q及C3c沉积与糖尿病肾病进展的相关性。方法:纳入2011年1月至2019年7月在南京医科大学第一附属医院确诊的2型糖尿病肾病患者112例，其中男性83例（74.1%），年龄（51.22±11.12）岁，随访时间19.0（8.5，31.3）个月。根据肾小球C1q和C3c是否沉积分为四组：C1q无沉积C3c无沉积组（n n=38）、C1q无沉积C3c沉积组（n n=24）、C1q沉积C3c无沉积组（n n=14）和C1q沉积C3c沉积组（n n=36），检测24 h尿蛋白等临床指标并收集病理资料。采用Cox回归及Kaplan-Meier生存曲线评估肾C1q和C3c沉积对肾脏预后的影响。n 结果:四组间24 h尿蛋白差异有统计学意义［分别为1.84（0.92，3.89），4.19（2.09，6.50）3.30（1.84，6.70），3.64（2.49，7.22）g/24 h，n P<0.01］，C1q沉积C3c沉积组24 h尿蛋白定量显著高于C1q无沉积C3c无沉积组（n P<0.01）。Kaplan-Meier生存曲线结果提示，四组累积生存率差异有统计学意义（Log-rank χ2n =8.785，n P<0.05），C1q沉积C3c无沉积组累计生存率最低，预后最差。调整后的多因素Cox分析显示，肾小球C1q和C3c共沉积［风险比（HR）2.260，95%可信区间1.329~3.845，n P<0.01］、肾小球C1q+C3c+IgM均沉积（HR=4.142，95%可信区间 1.071~16.021，n P<0.05）是肾脏预后的独立危险因素。n 结论:肾小球C1q及C3c沉积与糖尿病肾病患者蛋白尿、较差的肾功能和预后不良相关，且肾小球C1q和C3c共沉积是糖尿病肾病进展的独立危险因素。“,”Objective:To explore the association of glomerular deposition of complement C3c and C1q with baseline clinicopathological characteristics and the prognosis of type 2 diabetic patients with diabetic kidney disease (DKD).Methods:A total of 112 patients with DKD diagnosed in the First Affiliated Hospital of Nanjing Medical University from January 2011 to July 2019 were recruited in this study. Among them, 83 patients (74.1%) were males. The average age were (51.22±11.12) years with 19.0 (8.5, 31.3) months of follow-up. According to the glomerular deposition of C1q and C3c, all patients were divided into four groups: C1q non-deposited and C3c non-deposited group (n n=38), C1q non-deposited but C3c deposited group (n n=24), C1q deposited but C3c non-deposited group (n n=14) and C1q deposited and C3c deposited group (n n=36). Clinical indicators such as 24 h urine protein were detected and pathological data were collected. Cox regression and Kaplan-Meier survival curve were used to evaluate the effect of renal C1q and C3c deposition on renal prognosis.n Results:There were significant differences of 24 h urine protein among the four groups [1.84 (0.92, 3.89), 4.19 (2.09, 6.50), 3.30 (1.84, 6.70), 3.64 (2.49, 7.22) g/24 h, respectively,n P<0.01]. The 24 h urine protein in C1q deposited and C3c deposited group was significantly higher than that in C1q non-deposited and C3c non-deposited group (n P<0.01). Kaplan-Meier survival curve results showed that the cumulative survival rates of the four groups were statistically different (Log-rank χ2n =8.785, n P<0.05), and C1q deposited but C3c non-deposited group had the lowest cumulative survival rate and the worst prognosis. Adjusted multivariate Cox analysis showed that both the co-deposition of glomerular C1q and C3c (hazard ratio=2.260, 95% confidence interval was 1.329-3.845,n P<0.05) and glomerular C1q+C3c+IgM (hazard ratio=4.142, 95% confidence interval was 1.071-16.021,n P<0.05) were independent risk factors for renal prognosis.n Conclusion:Glomerular C3c and C1q deposition are associated with deteriorated renal function and prognosis in patients with DKD. Glomerular C1q and C3c co-deposition is an independent risk factor for DKD progression.