血小板/淋巴细胞比值对2型糖尿病患者发生糖尿病视网膜病变的诊断价值研究

Value of Platelet-to-lymphocyte Ratio in the Diagnosis of Diabetic Retinopathy in Type 2 Diabetes

目的评估血小板/淋巴细胞比值(PLR)对2型糖尿病患者发生糖尿病视网膜病变(DR)的诊断价值。方法选取2012年6月—2014年11月在桂林市人民医院内分泌科确诊的401例2型糖尿病患者,其中DR患者200例,非糖尿病视网膜病变(NDR)患者201例。患者均清晨空腹抽取静脉血,检测PLR及生化指标。绘制受试者工作特征(ROC)曲线评估PLR诊断发生DR的价值。结果患者的PLR为(113.7±56.0),PLR预测2型糖尿病患者发生DR的灵敏度为63.5%,特异度为69.2%,ROC曲线下面积(AUC)为0.70[95%CI(0.65,0.75)],截断值为103.9。DR和NDR患者性别、年龄、糖尿病病程、PLR、空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、高密度脂蛋白(HDL)、尿微量清蛋白(UMA)水平比较,差异有统计学意义(P<0.05)。结论 PLR对DR的发生有良好的临床诊断价值,可推荐作为2型糖尿病患者的定期随访项目。

Objective To evaluate the value of platelet-to-lymphocyte ratio（PLR） in the diagnosis of diabetic retinopathy（DR） in type 2 diabetes.Methods The participants were 401 cases diagnosed with type 2 diabetes in Endocrine Department,Guilin People＇s Hospital from June 2012 to November 2014,including 200 complicated with DR（DR group）,and 201 without（NDR group）.Levels of biochemical markers venous blood sampled in early morning fasting state were measured and PLR was calculated.The value of PLR in the diagnosis of DR was assessed by the receiver operating characteristic（ROC） curve.Results The value of PLR in two groups was（113.7 ± 56.0）.The area under the ROC curve（AUC） of PLR for the diagnosis of DR in type 2 diabetes was 0.70 [95% CI（0.65,0.75） ],the optimal cut-off value was 103.9,with a sensitivity of 63.5% and a specificity of 69.2%.DR group and NDR group differed significantly in gender,age,course of diabetes,PLR value,levels of fasting blood glucose（FBG）,glycosylated hemoglobin（Hb A1c）,high-density lipoprotein（HDL）,and urine microalbuminuria（UMA）（P〈0.05）.Conclusion PLR plays a positive role in the diagnosis of DR in type 2 diabetes.Therefore,it may be recommended as a follow-up item for diabetes.