血清C肽、NLR联合肾动脉阻力指数对2型糖尿病肾病的诊断价值

杨静静; 朱婉婉; 黄帅; 李梦旭; 吴倩; 赵丽丽; 蒋影

doi:10.13898/j.cnki.issn.2097-5252.2025.08.016

血清C肽、NLR联合肾动脉阻力指数对2型糖尿病肾病的诊断价值

Study on the diagnostic value of serum C-peptide and NLR combined with renal artery resistance index in type 2 diabetic nephropathy

摘要

摘要: 目的: 探究血清C肽(C-P)、中性粒细胞与淋巴细胞比值(NLR)联合肾动脉阻力指数(RI)对2型糖尿病肾病肌酐、血尿素氮病人的诊断价值。方法: 选取216例2型糖尿病病人，将其分为糖尿病肾病(DN)组129例和非DN(NDN)组87例。于病人入院后24 h内，收集并分析2组病人的一般临床资料，检测病人血液相关指标、肾功能指标以及血清C-P、NLR等指标水平值，采用彩色多普勒超声检测病人的RI值，比较2组病人相关指标的差异性，采用多因素logistic回归分析DN病人的影响因素，应用Pearson相关性分析血清C-P、NLR以及RI与DN的相关性，根据受试者工作特征(ROC)曲线下面积评价血清C-P、NLR、RI单一检测以及联合检测对DN的诊断价值。结果: 单因素分析显示，DN组在糖尿病病程、糖尿病视网膜病变发病率、血清肌酐、血尿素氮、NLR以及RI水平值方面明显高于NDN组(P < 0.05)，血清C-P、肾小球滤过率(eGFR)水平值明显较NDN组更低(P < 0.05)；多因素logistic回归分析得出，病人糖尿病病程较长、合并糖尿病视网膜病变、血清NLR水平值以及RI值升高、C-P、eGFR水平值降低是DN的主要影响因素；通过Pearson相关性分析得出，血清C-P水平表达与DN呈负相关(r=-0.298，P < 0.01)，NLR、RI与DN呈正相关(r=0.421，P < 0.01；r=0.382，P < 0.01)；ROC曲线结果显示，血清C-P、NLR以及RI联合检测诊断DN的AUC高于各指标单独检测(P < 0.05)。结论: 血清C-P、NLR以及RI对DN具有良好的诊断价值，其中血清C-P水平值降低、NLR水平值与RI值升高是导致DN的影响因素，临床应根据上述指标检测结果及早进行干预，此外，联合检测三者水平值对DN的诊断效能较单一指标检测更高。

Abstract: Objective: To explore the diagnostic value of serum C-peptide(C-P), neutrophil to lymphocyte ratio(NLR) and renal artery resistance index(RI) in patients with type 2 diabetic nephropathy(DN). Methods: A total of 216 patients with type 2 diabetes mellitus were divided into the DN group(129 cases) and non-DN (NDN) group(87 cases).Within 24 hours after admission, the general clinical data of two groups were collected and analyzed.The blood related indicators, renal function indicators, serum C-P, NLR and other indicators were detected, and the RI values were measured using color Doppler ultrasound.The differences in relevant indicators between two groups were compared.Multivariate logistic regression was used to analyze the influencing factors of DN patients, and Pearson correlation analysis was used to analyze the correlation between serum C-P, NLR and RI and DN.The diagnostic value of single detection and combined detection of serum C-P, NLR and RI for DN was evaluated based on the area under the receiver operating characteristic(ROC) curve. Results: The results of univariate analysis showed that the diabetes course, incidence of diabetic retinopathy and serum levels of SCr, BUN, NLR and RI in the DN group were significantly higher than those in NDN group(P < 0.05), and the serum levels of C-P and eGFR were significantly lower than those in NDN group(P < 0.05).The results of multivariate logistic regression analysis showed that the longer course of diabetes, combination of diabetic retinopathy, increase of serum NLR and RI and decrease of C-P and eGFR levels were the main influencing factors of DN.According to Pearson correlation analysis, the serum C-P expression was negatively correlated with DN(r=-0.298, P < 0.01), while the NLR and RI were positively correlated with DN(r=0.421, P < 0.01;r=0.382, P < 0.01).The ROC curve results showed that the AUC of combined detection of serum C-P, NLR and RI for diagnosis of DN were higher than that of each index alone(P < 0.05). Conclusions: The serum C-P, NLR and RI have good diagnostic value for DN.Among them, the decrease of serum C-P level value, increase of NLR level value and RI value are the influencing factors leading to DN.Clinically, intervention should be carried out as early as possible based on the detection results of the above indicators.In addition, the combined detection of the levels of the three has a higher diagnostic efficacy for DN than the detection of a single indicator.

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