社区老年糖尿病肾病患者系统免疫炎症指数分析及其临床价值研究
nalysis of systemic immune and inflammatory index and its clinical value in elderly patients with diabetes nephropathy in community
背景 糖尿病肾病（DKD）是一种发生在肾脏微血管的糖尿病常见并发症，其早期诊断、积极防治是改善预后的关键。血液炎性指标可能与DKD存在相关性。目的 探究系统免疫炎症指数（SII）与社区老年DKD的相关性。方法 回顾性分析2021年1月至2021年12月就诊于我社区的65岁以上老年2型糖尿病患者327例，同时选取100例健康体检者作为对照组。根据白蛋白／肌酐比值（UACR）将糖尿病患者分为单纯糖尿病组，微量尿蛋白组和大量尿蛋白组。分析各组受检者的一般情况，血常规检查结果，评估中性粒细胞/淋巴细胞比值（NLR）、淋巴细胞/单核细胞比值（PLR）、SII，中性粒细胞等指标和DKD的相关性。结果 Pearson相关性分析显示，SII（r=0.478，P=0.001），NLR（r=0.414，P<0.001），PLR（0.148，P=0.002）和DKD均呈正相关。logistic 回归分析显示，SII（OR=1.006，95%CI 1.005-1.007， P<0.001）、NLR（OR=3.233，95%CI2.365-4.418，P<0.001）、PLR（OR=1.011，95%CI 1.005-1.017，P<0.001）均是DKD的的危险因素。受试者工作特征曲线（ROC）曲线显示，SII（截断值=492.08， AUC=0.788，特异度=72.17%，灵敏度=74.65%）对DKD的诊断效能优于NLR（截断值=1.99，AUC=0.745，特异度=57.55%，灵敏度=80.60%）和PLR（截断值=117.36，AUC=0.617，特异度=52.36%，敏感度=66.82%）。结论 SII与DKD有明显相关性，可尝试在基层医院应用。
Background Diabetes nephropathy (DKD) is a common chronic microvascular complication in patients with diabetes. Early diagnosis and active prevention of DKD is the key to improve the prognosis. The blood inflammatory index may be related to DKD. Objective To explore the relationship between systemic immune-inflammation index (SII) and elderly patients with DKD in community. Methods The clinical data of 327 elderly patients over 65 years old with type?2?diabetes?mellitus in our community from January 2021 to December 2021 were retrospectively analyzedMoreover, 100 healthy people who came to the community for physical examination during the same period were selected as the control group. According to the UACR, 327 patients were divided into diabetes mellitus group, micro urinary protein group and large urinary protein group. The general situation and routine blood test in each group were compared. The correlations of DKD with neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and SII were analyzed. Results Pearson correlation analysis showed that SII (r=0.478P=0.001)NLR (r=0.414P<0.001)PLR (0.148P=0.002) were positively related with DKD. Logistic regression analysis showed that SII (OR=1.006, 95%CI 1.005-1.007, P<0.001), NLR (OR=3.233, 95%CI2.365-4.418, P<0.001), PLR (OR=1.011, 95%CI 1.005-1.017, P<0.001) were risk factors of DKD. Receiver operating characteristic (ROC) showed that SII (cutoff=492.08, AUC=0.788, specificity=72.17%, sensitivity=74.65%) had higher diagnostic value for DKD than NLR(cutoff =1.99, AUC=0.745, specificity =57.55%sensitivity =80.60%), PLR (cutoff =117.36, AUC=0.617, specificity 52.36%, sensitivity 66.82%) . Conclusion SII is the risk factor for DKD early and could be used as a predictor of DKD.
李卫民、姜瑞霞、赵丽珍
内科学临床医学基础医学
系统免疫炎症指数糖尿病肾病相关性
李卫民,姜瑞霞,赵丽珍.社区老年糖尿病肾病患者系统免疫炎症指数分析及其临床价值研究[EB/OL].(2022-12-23)[2025-08-11].https://chinaxiv.org/abs/202212.00171.点此复制
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