血小板与淋巴细胞比值对糖尿病神经源性膀胱的诊断价值

Value of platelet to lymphocyte ratio in diagnosis of diabetic neurogenic bladder

目的分析血小板与淋巴细胞比值(PLR),以及中性粒细胞与淋巴细胞比值(NLR)对糖尿病神经源性膀胱的诊断价值。方法回顾性分析2019-01至2022-12在第909医院诊断为糖尿病神经源性膀胱138例患者和单纯2型糖尿病患者307例临床资料。采用logistic回归分析糖尿病神经源性膀胱发生的独立危险因素。使用受试者工作特征曲线(ROC)分析危险因素诊断糖尿病神经源性膀胱效能。结果与单纯糖尿病组相比,糖尿病神经源性膀胱组的女性比例高、年龄大、糖尿病史时间长,合并有糖尿病肾病、动脉粥样硬化比例均高,空腹血糖水平、PLR、NLR、血尿素氮水平高;而BMI、吸烟史、饮酒史比例红细胞、血红蛋白水平、总胆红素、直接胆红素、间接胆红素、白蛋白、尿酸水平低(P<0.05)。糖尿病史时间长[OR=1.127,95%CI(1.037~1.223),P=0.003]、PLR升高[OR=1.408,95%CI(1.130~1.753),P=0.001]是糖尿病神经源性膀胱发生独立危险因素,总胆红素[OR=0.881,95%CI(0.792~0.979),P=0.021]和血红蛋白[OR=0.956,95%CI(0.924~0.988),P=0.007]降低是其保护因素。ROC曲线分析示,PLR的曲线下面积最大为0.897,最佳诊断切点为101.19,此时敏感度和特异度分别为83.3%和76.6%。结论糖尿病神经源性膀胱患者的PLR、NLR值较单纯糖尿病患者更高。PLR对糖尿病人群中发生神经源性膀胱具有一定诊断价值。

Objective To analyze the relationship between the value of platelet to lymphocyte ratio(PLR)and neutrophil to lymphocyte ratio(NLR)in the diagnosis of diabetic neurogenic bladder.Methods The clinical data of 138 patients with diabetic neurogenic bladder and 307 patients with type 2 diabetes mellitus diagnosed in the 909th Hospital from January 2019 to December 2022 were retrospectively analyzed.Logistic regression was used to analyze the independent risk factors for diabetic neurogenic bladder development.The receiver operating characteristic curve(ROC)was used to analyze the risk factors to the diagnostic efficacy of diabetic neurogenic bladder.Results Compared with the simple diabetes mellitus group,the diabetic neurogenic bladder group had a higher proportion of women,older age,a longer history of diabetes,a higher proportion of diabetic nephropathy and atherosclerosis,and a higher level of fasting blood glucose,PLR,NLR and blood urea nitrogen.The proportion of BMI,smoking history and drinking history was lower,and the levels of erythrocyte,hemoglobin,total bilirubin,direct bilirubin,indirect bilirubin,albumin and uric acid were even lower(P<0.05).Long history of diabetes[OR=1.127,95%CI(1.037-1.223),P=0.003]and an elevated PLR[OR=1.408,95%CI(1.130-1.753),P=0.001]were independent risk factors for diabetic neurogenic bladder development,while low levels of total bilirubin[OR=0.881,95%CI(0.792-0.979),P=0.021]and decreased hemoglobin[OR=0.956,95%CI(0.924-0.988),P=0.007]were protective factors.The result of ROC showed that the maximum area under the curve of PLR was 0.897,and the best diagnostic cut point was 101.19,at which time the sensitivity and specificity were 83.3%and 76.6%respectively.Conclusions PLR and NLR values of patients with diabetic neurogenic bladder are higher than those of patients with diabetes mellitus alone.PLR is valuable in the diagnosis of neurogenic bladder in diabetic patients.