PMA及PNA在预测2型糖尿病并发肾病变中的实用价值

Practical value of PMA and PNA for predicting complicating nephropathy in type 2 diabetes mellitus

目的探讨血小板-中性粒细胞聚集体(PNA)、血小板-单核细胞聚集体(PMA)检测在预测2型糖尿病并发症中的实用价值。方法应用流式细胞仪检测2型糖尿病并发肾病变患者血浆的PMA、PNA,并以无并发症的2型糖尿病患者和健康人作为对照,比较上述三组PMA、PNA的水平,用ROC曲线评价此试验的临床应用价值。结果 2型糖尿病并发肾病变组PMA、PNA水平显著高于无并发症组,而后者又显著高于健康对照。ROC曲线显示,PMA对2型糖尿病患者并发肾病变诊断临界值灵敏度为96.7%,特异性为100.0%,截断点为40.12%;PNA灵敏度为96.7%,特异性为88.3%,截断点为26.98%,可见PMA优于PNA。曲线下面积分别为0.986和0.963。结论 PMA、PNA可以预测2型糖尿病肾病变,应用流式细胞法检测其灵敏度和特异性均较满意,PMA特异性优于PNA。

Objective To evaluate the practical value of the platelet‐monocyte aggregates（PMA） and platelet‐neutrophils aggregates （PNA ） detection in predicting the complications of type 2 diabetes mellitus （T2DM ） . Methods Plasma PMA and PNA were detected in 90 cases of T2DM complicating nephropathy ,30 cases of T2DM without complications and 30 healthy persons as the control .The PMA and PNA levels were compared among 3 groups and the clinical application value of this experiment was evaluated by the ROC curves .Results The plasma PMA and PNA levels in the T2DM complicating nephropathy were significantly higher than that in the T2DM with‐out complications group ,and which in the latter were significantly higher than those in the healthy controls .The ROC curves indicated that the critical values of PMA for diagnosing T2DM complicating nephropathy were the sensitivity of 96 .7% ,specificity of 100 .0% and cut off point of 40 .12% ,which of PNA were the sensitivity of 96 .7% ,specifici‐ty of 88 .3% and cut off point of 26 .98% ,showing that PMA was superior to PNA .The area under the curve（AUC） was 0 .986 and 0 .963 respectively .Conclusion PMA and PNA can be used to predict the complicating renal lesion inT2DM ,the sensitivity and specificity by using the flow cytometry for detecting PNA and PM A are more satisfacto‐ry ,but the specificity of PM A is better than that of PNA .