红细胞分布宽度联合中性粒细胞/淋巴细胞比值诊断妊娠期糖尿病的价值

The value of erythrocyte distribution width combined with neutrophil/lymphocyte ratio in diagnosis of gestational diabetes mellitus

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者中红细胞分布宽度(red cell volume distribution width,RDW)和中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)的变化。方法选取2017年11月-2018年11月于杭州师范大学附属医院就诊的GDM患者82例为观察组,另取同期正常妊娠孕妇82例为对照组。分析各组孕妇的临床资料、空腹血糖(FPG)、餐后1 h血糖(1 h FPG)、餐后2 h血糖(2 h FPG)、糖化血红蛋白(Hb A1c)、RDW和NLR的水平变化。以血糖检测诊断结果为标准,对RDW和NLR联合诊断GDM的准确度和灵敏度进行评价。结果GDM组孕妇在年龄、孕前BMI和孕前体质量等方面与对照组相比,差异均无统计学意义(P>0.05),GDM组孕妇在孕期BMI和孕期体质量方面与对照组比较,差异有统计学意义(P<0.05)。GDM组孕妇的FPG、1 h FPG、2 h FPG、Hb A1c、RDW和NLR高于观察组,差异有统计学意义(P<0.05)。RDW和NLR联合诊断GDM的准确度和灵敏度分别为90.2%和76.8%。结论RDW、NLR与GDM的发生密切相关,联合检测可用于诊断和预防GDM。

Objective To investigate the change of red cell volume distribution width(RDW)and neutrophil to lymphocyte ratio(NLR)in patients with gestational diabetes mellitus(GDM).Methods A total of 82 patients with GDM who were treated in the Affiliated Hospital of Hangzhou Normal University from November 2017 to November 2018 were selected as the observation group,and 82 normal pregnant women in the same period were selected as the control group.The clinical data,fasting blood glucose(FPG),postprandial blood glucose(1 h FPG),postprandial blood glucose(2 h FPG),glycosylated hemoglobin(HbA1c),RDW and NLR levels of pregnant women in each group were analyzed.The accuracy and sensitivity of the combined diagnosis of RDW and NLR for GDM were evaluated based on the results of blood sugar detection and diagnosis.Results There was no statistical significance on the difference in age,BMI and weight before pregnancy between GDM group and control group(P>0.05).BMI and weight during pregnancy in GDM group were different from those in control group(P<0.05).The FPG,1 h FPG,2 h FPG,HbA1c,RDW and NLR of pregnant women in GDM group were higher than those in the observation group,and the differences were statistically significant(P<0.05).The accuracy and sensitivity of RDW and NLR in the diagnosis of GDM were respectively 90.2%and 76.8%.Conclusion RDW and NLR are closely related to the occurrence of GDM,and combined detection can be used to diagnose and prevent GDM.