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目的:探讨糖尿病肾病(DN)的危险因素。方法:回顾性分析2016年1月至2019年9月于温州市中西医结合医院就诊的2型糖尿病患者403例的临床资料，排除其他因素后，根据是否合并DN分为2型糖尿病组(DM组)(315例)和DN组(88例)，将年龄、病程、合并症、单核细胞与高密度脂蛋白的比值(MHR)等资料纳入多因素logistic回归模型中，分析DN的相关因素。结果:DM组和DN组病程≥10年[95例(30.16%)比37例(42.05%)]、合并高血压[141例(44.76%)比58例(65.91%)]、胰岛素应用[94例(29.84%)比39例(44.32%)]、血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体拮抗剂应用[132例(41.90%)比62例(70.45%)]、空腹血糖[(7.38±2.45)mmol/L比(8.26±2.06)mmol/L]、糖化血红蛋白(HbA1c)≥7%占比[91例(28.89%)比36例(40.91%)]、MHR[(10.30±4.38)比(17.10±7.18)]、高密度脂蛋白胆固醇[(0.58±0.16)mmol/L比(0.52±0.17)mmol/L]差异均有统计学意义(n t＝4.41、13.31、6.52、22.46、3.08、4.60、11.02、2.65，均n P<0.05)。多因素logistic回归结果显示，高血压(n OR＝2.06，95%n CI＝1.36～2.76)、HbA1c≥7%(n OR＝1.32，95%n CI＝1.04～1.60)、MHR≥11.78(n OR＝1.65，95%n CI＝1.03～2.67)与DN独立相关。n 结论:高血压、HbA1c≥7%、MHR≥11.78是DN的独立危险因素，为临床判断提供依据。“,”Objective:To explore the risk factors of diabetic nephropathy(DN).Methods:From January 2016 to September 2019, the clinical data of 403 patients with type 2 diabetes in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were analyzed retrospectively.Excluding other factors, they were divided into DM group (315 cases) and DN group(88 cases) according to whether or not they were complicated with DN.The age, course of disease, complications, monocyte to high-density lipoprotein cholesterol ratio(MHR) and other test data were included in the logistic regression model to analyze the independent risk factors of DN.Results:There were statistically significant differences in the course of ≥10 years[95 cases(30.16%) vs.37 cases(42.05%)], complicated with hypertension[141 cases(44.76%) vs.58 cases(65.91%)], insulin application[94 cases(29.84%) vs.39 cases(44.32%)], ACEI/ARB application[132 cases(41.90%) vs.62 cases(70.45%)], FBG[(7.38±2.45)mmol/L vs.(8.26±2.06)mmol/L], HbA1c≥7%[91 cases(28.89%) vs.36 cases(40.91%)], MHR[(10.30±4.38) vs.(17.10±7.18)] and HDL-C[(0.58±0.16)mmol/L vs.(0.52±0.17)mmol/L] between the two groups(n t=4.41, 13.31, 6.52, 22.46, 3.08, 4.60, 11.02, 2.65, all n P<0.05). Multivariate logistic regression analysis showed that hypertension(n OR=2.06, 95%n CI=1.36-2.76), HbA1c≥7%(n OR=1.32, 95%n CI=1.04-1.60), MHR≥11.78(n OR=1.65, 95%n CI=1.03-2.67) were independent risk factors for DN.n Conclusion:Hypertension, HbA1c ≥7%, MHR ≥11.78 are independently correlated with DN, which provide a basis for clinical prognosis.