血小板与淋巴细胞比值在糖尿病视网膜病变中的诊断价值

Platelet-to-lymphocyte ratio as potential biomarker in the diagnosis of diabetic retinopathy

目的评估血小板与淋巴细胞比值(PLR)能否作为视网膜糖尿病临床诊断指标之一。方法选取94例Ⅱ型糖尿病无视网膜病变患者和92例糖尿病视网膜病变患者为研究对象,选取91例健康人为对照组。利用Sysmex 4000全血细胞分析仪检测患者血小板、淋巴细胞等血液学指标,视网膜病变分级采用国际临床糖尿病性视网膜病变严重程度评分,运用单因素方差分析(ANOVA)和受试者工作特征曲线(ROC)评价PLR在诊断糖尿病视网膜病变的临床价值。结果糖尿病视网膜病变患者PLR显著高于糖尿病无视网膜病变患者和健康人群(P<0.001),且糖尿病视网膜增殖期病变患者的PLR值也显著高于非增殖期病变患者(P=0.000 4)。ROC曲线分析显示,当PLR高于107.5时,在诊断糖尿病视网膜病变时的曲线下面积为0.724,诊断的特异性和敏感性分别为65.2%和64.9%。结论糖尿病视网膜病变患者PLR比值的升高与临床分期相关,PLR比值是诊断糖尿病视网膜病变的良好指标之一。

Objective To investigate the relationship between platelet-to-lymphocyte ratio （PLR） and diabetic reti- nopathy （DR）. Methods We analyzed 94 cases of type ]l diabetic patients without retinopathy and 92 cases of di- abetic retinopathy（DR） patients retrospectively. 91 normal subjects matched with age and sex were taken as control group. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale. Differ- ences in PLR among patients and healthy subjects were assessed by using unpaired Student t test and one-way anal- ysis of variance （ANOVA）. Receiver operating characteristic （ROC） curves were used to evaluate the sensitivity and specificity of PLR, PLT and lymphocytes in DR. Results The mean PLR values of the patients were signifi- cantly higher than those of the healthy control group （ P 〈 0. 001 ）, and PLR values of the patients with DR were higher than those of the patients without DR （P = 0. 000 4 ）. When cut-off value of PLR was 107.50, the sensitivity and specificity of the PLR for DR diagnosis were 65.2% and 64.9% , respectively, with an area under the curve at 0. 724. The area under the curve （ AUC ） of PLR was 0. 724. Conclusion Our study demonstrates that higher PLR values would be a useful marker when evaluating diabetes patients with DR.