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目的探讨中性粒细胞/淋巴细胞的比值(NLR)、血小板/淋巴细胞比值(PLR)与糖尿病肾病(DN)之间的关系及其意义。方法将2014年6月至2015年8月120例合并DN的2型糖尿病患者分为正常白蛋白尿组(NA组)38例,尿微量白蛋白/肌酐比值(UMA/Cr)<30μg/mg;微量白蛋白尿组(MIA组)52例,UMA/Cr 31~300μg/mg;大量白蛋白尿组(MA)30例,UMA/Cr>300μg/mg。同时随机选择本院健康体检者30例作为对照组,比较4组间白细胞计数、中性粒细胞、血小板、淋巴细胞、NLR、PLR及生化指标。结果各DN组糖化血红蛋白(Hb A1c)、总胆固醇(TC)、血清肌酐(Cre)、UMA/Cr水平较对照组升高(P均<0.05)。与对照组相比,NA组、MIA组、MA组中性粒细胞数、白细胞计数、NLR、PLR、血小板水平增高,淋巴细胞数降低(P均<0.05),且DN 3组间比较差异也均有统计学意义(P均<0.05)。4组间单核细胞数比较差异无统计学意义(P均>0.05)。Hb A1c、NLR、PLR是DN的危险因素(P<0.05或P<0.01)。结论 NLR、PLR的升高与DN有关,且NLR、PLR有可能成为预测早期DN的新指标。
Objective To investigate the relationship between neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio (PLR) and diabetic nephropathy (DN). Methods One hundred and twenty patients with type 2 diabetes mellitus with DN were divided into normal albuminuria group (NA group), 38 patients (UMA / Cr) <30μg / mg from June 2014 to August 2015 ; Microalbuminuria group (MIA group) 52 cases, UMA / Cr 31 ~ 300μg / mg; a large number of albuminuria group (MA) 30 cases, UMA / Cr> 300μg / mg. At the same time, 30 healthy subjects in our hospital were randomly selected as the control group. The white blood cell count, neutrophil, platelet, lymphocyte, NLR, PLR and biochemical indexes were compared among the 4 groups. Results The levels of Hb A1c, TC, Cre and UMA / Cr in DN group were higher than those in control group (all P <0.05). Compared with the control group, neutrophil count, leukocyte count, NLR, PLR and platelet count increased, lymphocyte count decreased in NA group, MIA group and MA group (all P <0.05) All were statistically significant (P <0.05). There was no significant difference in the number of monocytes among 4 groups (all P> 0.05). Hb A1c, NLR and PLR were risk factors of DN (P <0.05 or P <0.01). Conclusion The increase of NLR and PLR is related to DN, and NLR and PLR may become new indexes to predict early DN.