红细胞体积分布宽度、平均血小板体积诊断2型糖尿病合并肺结核并发肺部感染的价值

Value of Red Cell Volume Distribution Width and Mean Platelet Volume in the Diagnosis of Patients with Type 2 Diabetes Mellitus Complicated with Pulmonary Tuberculosis and Pulmonary Infection

目的:分析红细胞体积分布宽度(red cell volume distribution width,RDW)、平均血小板体积(mean platelet volume,MPV)诊断2型糖尿病(type 2 diabetes mellitus,T2DM)合并肺结核患者并发肺部感染的价值。方法:选取2019年1月—2021年12月南通市第六人民医院收治的100例T2DM合并肺结核患者。根据肺部感染标准将其分为感染组(n=54)和非感染组(n=46)。收集两组临床资料,检测两组实验室指标。比较两组临床资料及实验室指标,分析T2DW合并肺结核患者RDW与MPV的相关性,分析T2DM合并肺结核患者并发肺部感染的危险因素,以及RDW、MPV诊断T2DM合并肺结核并发肺部感染的价值。结果:感染组糖尿病病程长于非感染组,肺部病灶5~6个占比、空腹血糖(fasting blood glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、RDW、MPV均明显高于非感染组(P<0.05)。Pearson相关性分析显示,RDW与MPV呈正相关(r=0.331,P=0.001)。多因素logistic回归分析显示,糖尿病病程、肺部病灶(5~6个)、RDW、MPV均为T2DM合并肺结核患者并发肺部感染的独立危险因素(P<0.05)。ROC曲线分析显示,RDW、MPV指标单独诊断T2DM合并肺结核患者并发肺部感染的AUC分别为0.688、0.790,RDW联合MPV诊断T2DM合并肺结核患者并发肺部感染的AUC为0.863(P<0.05)。结论:RDW、MPV在T2DM合并肺结核并发肺部感染患者外周血中明显高表达,两者呈明显正相关,可能相互影响,是T2DW合并肺结核患者并发肺部感染的危险因素,具有一定的诊断价值,两者联合诊断价值更高,早期监测指标变化可能帮助评估并发肺部感染风险。

Objective:To analyze the value of red cell volume distribution width(RDW)and mean platelet volume(MPV)in the diagnosis of patients with type 2 diabetes mellitus(T2DM)complicated with pulmonary tuberculosis and pulmonary infection.Method:A total of 100 patients with T2DM complicated with pulmonary tuberculosis admitted to Nantong Sixth People's Hospital from January 2019 to December 2021 were selected.They were divided into the infected group(n=54)and the non-infected group(n=46)according to the pulmonary infection criteria.The clinical data of the two groups was collected,and the laboratory indicators of the two groups were detected.The clinical data and laboratory indicators of the two groups were compared,the correlation between RDW and MPV in patients with T2DM complicated with pulmonary tuberculosis was analyzed,the risk factors of pulmonary infection in patients with T2DM complicated with pulmonary tuberculosis were analyzed,and the value of RDW and MPV in the diagnosis of pulmonary infection in patients with T2DM complicated with pulmonary tuberculosis was analyzed.Result:The course of diabetes in the infected group was longer than that in the non-infected group,the proportion of 5-6 lung lesions,fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),RDW and MPV in the infected group were significantly higher than those in the non-infected group(P<0.05).Pearson correlation analysis showed that RDW was positively correlated with MPV(r=0.331,P=0.001).Multivariate logistic regression analysis showed that the course of diabetes,lung lesions(5-6),RDW and MPV were independent risk factors for patients with T2DM complicated with pulmonary tuberculosis and pulmonary infection(P<0.05).ROC curve analysis showed that the AUC of RDW and MPV in the diagnosis of patients with T2DM complicated with pulmonary tuberculosis and pulmonary infection were 0.688 and 0.790 respectively,and the AUC of RDW combined with MPV in the diagnosis of patients with T2DM complicated with pulmonary tuberculosis and pulmonary infection was 0.863(P<0.05).Conclusion:RDW and MPV are highly expressed in peripheral blood of patients with T2DM complicated with pulmonary tuberculosis and pulmonary infection,and there is a significant positive correlation between them,which may affect each other.They are risk factors of patients with T2DM complicated with pulmonary tuberculosis and pulmonary infection,and have certain diagnostic value.The combination of RDW and MPV has a higher diagnostic value.Early monitoring of changes in indicators may help assess the risk of concurrent lung infections.