Abstract:

Objective　To explore the value of conventional inflammatory markers and novel inflammation indicators in the prediction of urinary tract infections in patients with diabetic nephropathy and uremia. Methods　One hundred and twenty-two patients with diabetic nephropathy and uremia treated at First Affiliated Hospital of Xi'an Jiaotong University from January to December 2022 were selected for the randomized controlled trial, and were divided into an infected group (45) and an uninfected group (77 cases) according to whether they had urinary tract infections. The basic data and levels of conventional inflammatory markers and novel inflammation indicators [systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR)] were compared between the two groups. The logistic regression analysis was used to identify the factors influencing urinary tract infections in the patients. A nomogram model was constructed, and its fit was assessed. χ² and t tests were used for the statistical analysis. Results　The levels of interleukin-6, C-reaction protein, and tumor necrosis factor-α in the infected group were (17.70±2.31) ng/L, (15.49±2.23) mg/L, and (6.98±1.25) ng/L, which were higher than those in the uninfected group (all P<0.05). The SII, NLR, PLR, and LMR in the infected group were 1 569.54±362.82, 3.13±0.71, 165.25±24.26, and 3.48±0.66, which were higher than those in the uninfected group (all P<0.05). The blood glucose levels, inflammatory marker levels, SII, NLR, PLR, and MLR were factors influencing the occurrence of urinary tract infections in the patients with diabetic nephropathy undergoing dialysis (all P<0.05). The calibration curve showed an average absolute error of 0.018, indicating high predictive accuracy. Conclusion　Inflammatory levels in patients with diabetic nephropathy and uremia can affect the occurrence of urinary tract infections.

Key words:

Inflammatory markers, Systemic immune-inflammation index, Risk factors, Nomogram model

摘要：

目的　探讨常规炎症因子及新型炎症标志物对糖尿病肾病尿毒症患者尿路感染的预测价值。方法　选取2022年1月至12月西安交通大学医学院第一附属医院收治的122例糖尿病肾病尿毒症患者进行病例对照研究，根据患者是否合并尿路感染将其分为感染组（45例）和未感染组（77例）。比较两组基本资料、常规炎症因子水平以及新型炎症标志物［全身免疫炎症指数（systemic immune-inflammation index，SII）、中性粒细胞/淋巴细胞比率（neutrophil to lymphocyte ratio，NLR）、血小板/淋巴细胞比值（platelet to lymphocyte ratio，PLR）以及淋巴细胞/单核细胞比值（lymphocyte to monocyte ratio，LMR）］。采用logistic回归分析筛选糖尿病肾病尿毒症患者发生尿路感染的影响因素，构建列线图预测模型，并评价模型的拟合效果。采用χ²检验和t检验进行统计分析。结果　感染组白细胞介素-6、C反应蛋白、肿瘤坏死因子-α水平分别为（17.70±2.31）ng/L、（15.49±2.23）mg/L、（6.98±1.25）ng/L，均高于未感染组（均P<0.05）。感染组SII、NLR、PLR、LMR分别为1 569.54±362.82、3.13±0.71、165.25±24.26、3.48±0.66，均高于未感染组（均P<0.05）。血糖水平、炎性因子水平、SII、NLR、PLR和MLR均是糖尿病肾病尿毒症患者合并尿路感染的影响因素（均P<0.05）。校准曲线显示，曲线的平均绝对误差为0.018，预测准确度高。结论　糖尿病肾病尿毒症患者的炎症水平会影响其尿路感染的发生。

关键词:

炎症标志物, 全身免疫炎症指数, 危险因素, 列线图模型