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背景:糖尿病病程和高血压是糖尿病微血管并发症发生的独立危险因素,而空腹C肽水平是其保护因素。糖化血红蛋白、C-反应蛋白、白细胞计数与糖尿病微血管并发症的相关研究报道较多,但关于中性粒细胞的报道较少。目的:分析外周血中性粒细胞计数与糖尿病微血管并发症的关系。方法:112例2型糖尿病患者根据是否合并微血管并发症将其分为2组:2型糖尿病合并微血管并发症组和2型糖尿病。收集2组患者性别、年龄、民族、既往史、实验室检查指标等各项临床资料,通过单因素及多因素分析进行统计学比较。结果与结论:1单因素分析结果显示:合并微血管病变组患者年龄、糖尿病病程、球蛋白、肌酐、中性粒细胞百分比、中性粒细胞绝对值、合并高血压的比率明显高于2型糖尿病组(P<0.05),然而合并微血管病变组淋巴细胞百分比、肾小球滤过率、三酰甘油水平明显低于2型糖尿病组(P<0.05)。2多因素Logistic回归分析结果示:患者的年龄、糖尿病病程、中性粒细胞绝对值是2型糖尿病患者发生微血管并发症的独立危险因素(OR=1.155、2.145、2.275,均P<0.01)。控制年龄因素后,对所有对象偏相关分析结果显示:中性粒细胞计数与肌酐、低密度脂蛋白胆固醇、球蛋白、血红蛋白呈正相关,与血胆汁酸、肾小球滤过率呈负相关。结果提示,慢性亚临床炎症反应与2型糖尿病患者微血管并发症的发生密切相关,中性粒细胞计数可作为预测2型糖尿病患者微血管并发症的一个指标。
BACKGROUND Diabetes mellitus and hypertension are independent risk factors for the development of microvascular complications in diabetes. The level of fasting C-peptide is the protective factor. HbAlc, C-reactive protein, leukocyte count and diabetic microvascular complications are reported in many studies, but few reports on neutrophils. Objective: To analyze the relationship between peripheral blood neutrophil count and diabetic microvascular complications. Methods: One hundred and twelve patients with type 2 diabetes were divided into two groups based on whether they had microvascular complications: type 2 diabetes with microvascular complications and type 2 diabetes mellitus. The clinical data of two groups including sex, age, ethnicity, past history and laboratory tests were collected and compared by single factor and multivariate analysis. RESULTS AND CONCLUSION: 1 The results of univariate analysis showed that the age, duration of diabetes, globulin, creatinine, neutrophil percentage, absolute neutrophil, and hypertension were significantly higher in patients with merger of microangiopathy than those in type 2 diabetes mellitus (P <0.05). However, the percentages of lymphocytes, glomerular filtration rate and triglyceride in patients with microangiopathy were significantly lower than those in type 2 diabetic patients (P <0.05). The multivariate Logistic regression analysis showed that the age, duration of diabetes, neutrophil absolute value were independent risk factors of microvascular complications in patients with type 2 diabetes (OR = 1.155,2.145,2.275, all P <0.01). After controlling for age, partial correlation analysis showed that the neutrophil count was positively correlated with creatinine, LDL cholesterol, globulin and hemoglobin, and negatively correlated with bile acid and glomerular filtration rate. The results suggest that chronic subclinical inflammatory response is closely related to the occurrence of microvascular complications in patients with type 2 diabetes mellitus, neutrophil count can be used as an indicator of microvascular complications in patients with type 2 diabetes mellitus.