2型糖尿病及其视网膜病变患者中性粒细胞/淋巴细胞比值变化和意义

摘要

目的：：分析糖尿病视网膜病变(DR)患者中性粒细胞(N)与淋巴细胞(L)比值(NLR)的变化和临床意义。方法：纳入研究对象183人,包括正常对照组(NC 组,n=55),单纯2型糖尿病组(DM 组,n=64),非增生性 DR 组(NPDR 组,n=28)和增生性 DR 组(PDR 组,n=36),各组均禁食10h 后采集空腹静脉血,采用核酸荧光染色和激光流式技术测定全血 N 及 L 计数,计算 NLR,采用葡萄糖氧化酶法测定空腹血糖(FPG)、免疫比浊法测定糖化血红蛋白(HbA1c)、电化学发光免疫分析法测定空腹胰岛素(FIN),计算稳态胰岛素抵抗指数(HOMA-IR)。比较各指标组间差异并分析 NLR 与 HOMA-IR 的相关性。结果：与 NC 组比较,DM 组、NPDR 组和 PDR 组患者 L 值、NLR 值均显著增高(P <0.05),PDR 组较 NPDR 组升高更明显(P <0.05)。DM 组、NPDR 组和 PDR 组 HbA1c、FPG、FINS、HOMA-IR水平均较 NC 组升高(P <0.05),尤以 PDR 组升高更显著(P <0.05)。相关性分析显示 DR 患者 NLR 与 HOMA-IR水平呈明显正相关(r=0.354,P <0.05)。结论：NLR 值可协同其它生物指标反映 DR 患者病情严重程度。%Objective:To explore the changes and significance of neutrophil-lymphocyte ratio (NLR)in pa-tients with type 2 diabetes and retinopathy(DR).Method:A total of 183 subjects were investigated,including 55 ca-ses of normal as control group (NC group),64 cases of type 2 diabetes mellitus (DM group),28 cases of non-prolif-erative retinopathy in type 2 diabetes (NPDR group)and 36 cases of proliferative retinopathy in type 2 diabetes (PDR group).All patients were blooding after fasting ten hours.The whole blood neutrophils and lymphocytes were measured by nucleic acid staining and laser flow cytometry technique and calculated neutrophil-lymphocyte ratio. Fasting blood glucose value (FPG)was measured by glucose oxidase method.Immunoassay glycated hemoglobin (HbA1c)was measured by immunonephelometry method.Fasting insulin (FINS)was measured by electrochemilu-minescence method,and homeostasis model assessment insulin resistance index (HOMA-IR).The differences be-tween groups and the relationship between the HOMA-IR and NLR were analyzed.Results:Compared with the NC group,DM group,NPDR group and PDR group patients L value,NLR value were significantly higher(P <0.05 ), PDR group increased more significantly(P <0.05).DM group,NPDR group and PDR group HBA1C,FPG,FINS, HOMA-IR than NC group increased(P <0.05),especially in the PDR group increased more significantly(P <0.05). NLR levels were positive correlated with the HOMA-IR(r=0.354,P <0.05).Conclusion:High levels of NLR could reflect the severity of diabetic retinopathy.