外周血NLR、MLR、PLR及血小板相关参数对2型糖尿病肾病的诊断价值-现代医学

外周血NLR、MLR、PLR及血小板相关参数对2型糖尿病肾病的诊断价值

单位：南京中医药大学附属医院检验科, 江苏南京 210029

关键词：2型糖尿病肾病中性粒细胞与淋巴细胞比率单核细胞与淋巴细胞比率血小板与淋巴细胞比率血小板相关参数

分类号：R446.11

出版年·卷·期（页码）：2021·49·第十期（1133-1137）

摘要：

目的：探讨外周血中性粒细胞与淋巴细胞比率（NLR）、单核细胞与淋巴细胞比率（MLR）、血小板与淋巴细胞比率（PLR）、血小板平均体积（MPV）、大血小板比率（P-LCR）及血小板分布宽度（PDW）对2型糖尿病肾病（T2DN）的诊断价值。方法：将南京中医药大学附属医院2018年3月至2021年3月收治的71例T2DN患者纳入研究组，同时将就诊于该院的93例单纯2型糖尿病（T2DM）患者纳入对照组，比较两组患者外周血NLR、MLR、PLR、MPV、P-LCR及PDW值，绘制受试者工作特征曲线（ROC曲线），评价这些指标在T2DN早期诊断中的价值；进一步根据估算肾小球滤过率（eGFR，单位为ml·min^-1·1.73 m^-2）将研究组分为eGFR>60组（25例）、15结果：T2DN患者外周血NLR、MLR及PLR值显著高于单纯T2DM患者（P<0.05）；而MPV、P-LCR及PDW值在两组间无显著差异。ROC曲线分析显示，NLR、MLR及PLR值对T2DN均具有一定的诊断价值，其中MLR的诊断灵敏度为84.51%，特异性为79.57%。此外，NLR及MLR值随T2DN进展而升高，差异具有统计学意义（P<0.05）。结论：T2DN患者外周血NLR、MLR及PLR值较单纯T2DM患者显著升高，三者在T2DN早期诊断中具有一定的应用价值，且NLR和MLR值在评估病情严重程度时具有一定的参考意义。

Objective: To explore the diagnostic value of neutrophil/lymphocyte ratio(NLR), monocyte/lymphocyte ratio(MLR), platelet/lymphocyte ratio(PLR), mean platelet volume(MPV), platelet-large cell ratio(P-LCR) and platelet distribution width(PDW) in the peripheral blood of patients with type 2 diabetic nephropathy(T2DN).Methods: 71 patients with T2DN treated in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from March 2018 to March 2021 were included in the study group, and 93 patients with simple type 2 diabetes(T2DM) were enrolled as the control group. The NLR, MLR, PLR, MPV, P-LCR and PDW were compared between the two groups. Also, the receiver operating characteristic(ROC) curve was drawn to investigate the value of these indicators in the early diagnosis of T2DN. Furthermore, patients with T2DN were divided into three groups based on estimated glomerular filtration rate(eGFR, ml·min^-1·1.73 m^-2). including eGFR>60(25 cases), 15Results: The levels of NLR, MLR and PLR in patients with T2DN are significantly higher than those in the control group(P<0.05), but there were no significant differences in MPV, P-LCR and PDW between the two groups. ROC curve indicated that the NLR, MLR and PLR had certain diagnostic value for T2DN, among which the sensitivity and specificity of MLR were 84.51% and 79.57%. In different stages of diabetic nephropathy, only the levels of NLR and MLR increased with the severity of the disease, and the difference was statistically significant(P<0.05). Conclusion: The levels of NLR, MLR and PLR in patients with T2DN are significantly higher than those in patients with simple T2DM, all of them have some value in the early diagnosis of T2DN. Moreover, the levels of NLR and MLR has a certain reference significance in evaluating the severity of T2DN.

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