中性粒细胞百分比值对糖尿病合并败血症患者的诊断价值

The value of neutral granular cell percentage ratio for the diagnosis on patients with diabetes mellitus combined with septicemia

目的探讨中性粒细胞百分比值(NEU%)对糖尿病合并败血症患者的诊断价值。方法回顾性分析该院内分泌科2015年7月至2017年5月住院的92例糖尿病疑似合并败血症患者、240例无感染的糖尿病病情稳定的患者(对照组)的临床资料,据双套血培养结果将疑似败血症患者分为血培养阳性组与血培养阴性组。采用Logistic回归及受试者工作特征曲线(ROC曲线)对NEU%进行诊断性评价。结果血培养阳性患者其NEU%值[91.5%(88.9%,95.1%)]和阴性组患者NEU%值[90.2%(79.9%,94.1%)]高于对照组[45.3%(40.0%,75.0%)],差异有统计学意义(P<0.001);同时,血培养阳性组NEU%水平高于血培养阴性组,其差异有统计学意义(P<0.001)。NEU%(OR=2.088,P=0.004)是糖尿病合并败血症的独立危险因素;NEU%诊断糖尿病合并败血症时的ROC曲线下面积为0.768,cut-off值为90.3%时,其对应的灵敏度为81.0%,特异度为50.7%。结论糖尿病合并感染时若NEU%值在90.3%以上,要警惕合并败血症的可能。

Objective To discuss the value of neutral granular cell percentage ratio（NEU%）in the diagnosis of patients with diabetes mellitus combined with septicemia.Methods Retrospective analysis was conducted in Affiliated Hospital of North Sichuan Medical College from July 2015 to May 2017,92 suspected septicemia cases with diabetes mellitus and 240 diabetes mellitus patients with no infection（control group）were recruited.According to the results of blood culture,92 suspected patients were divided into positive blood culture group and negative blood culture group.Logistic regression and ROC curves were performed to determine the diagnostic value of NEU%for diabetes mellitus with septicaemia cases.Results The level of NEU%in diabetes mellitus with positive blood culture patients[91.5%（88.9%,95.1%）]and negative blood culture patients[90.2%（79.9%,94.1%）]were significantly higher than the control group[45.3%（40.0%,75.0%）]（P〈0.001）.NEU% was one of the independent risk factor for diabetes mellitus with septicemia cases（OR=2.088,P=0.004）.ROC analysis showed that the area under curve of NEU% was 0.768.When the cut-off value was 90.3%,the sensitivity was 81.0%,specificity was 50.7%.Conclusion If the NEU% value is above90.3%in diabetes mellitus patients combined with infection,be aware of the possibility of a combination with septicemia.