外周血白细胞计数对2型糖尿病并发周围神经病变的早期诊断价值

Value of total white blood cell count in early diagnosis of early-stage diabetic peripheral nephropathy

目的研究外周血白细胞(WBC)计数对糖尿病周围神经病变(DPN)的诊断价值。方法收集194例2型糖尿病(T2DM)患者的临床资料,根据有无周围神经病变分为DPN组118例,单纯T2DM组76例,收集空腹血样本检测血常规和血脂、肾功能等生化指标。分析2组之间各指标差异,并对DPN的危险因素进行Logistic回归分析和绘制受试者工作特征(ROC)曲线评估WBC对DPN的诊断价值。结果DPN组WBC计数显著高于单纯T2DM组[(6.5±1.4)×10^9/L与(6.3±1.2))×10^9,P<0.05];Logistic回归分析结果提示,校正年龄、病程、尿酸、血脂等后,WBC[OR(95%CI)=1.541(1.125,2.112),P=0.007]仍是DPN的危险因素;ROC曲线结果提示,WBC的曲线下面积(AUC)(95%CI)为0.672(0.607,0.737),截断值取5.23时,WBC计数诊断DPN的敏感度为88.12%,特异度为41.14%。结论WBC是T2DM并发周围神经病变的独立危险因素,且WBC对DPN诊断的敏感度较高、特异性尚可。

Objective To investigate the diagnostic value of total white blood cell(WBC)count in diabetic peripheral neuropathy(DPN).Methods A total of 194 patients with type 2 diabetes mellitus(T2DM)were included,and according to presence of DPN,divided into two groups:DPN(n=118)and simple T2DM(n=76)groups.The two groups were examined and compared for fasting blood routine test,lipids and renal functions.The risk factors of DPN were analyzed by Logistic regression.Receiver operating characteristic(ROC)curve was generated to evaluate the diagnostic value of WBC for DPN.Results The WBC count in the DPN group was significantly higher than that in the T2DM group(6.5±1.4)×109/L vs(6.3±1.2)×109/L,P<0.05).Logistic regression analysis suggested that WBC[OR(95%CI)=1.541(1.125,2.112),P=0.007]was a risk factor of DPN after adjustment for age,disease duration,blood uric acid,and lipids.By ROC curve analysis,the area under the curve(AUC)of WBC was 0.672,95%CI(0.607,0.737).Using a cut-off of 5.23,WBC count identified DPN with a sensitivity of 88.12%and a specificity of 41.14%.Conclusion WBC is an independent risk factor for DPN,and offers high sensitivity and acceptable specificity in diagnosing DPN.