中性粒细胞/淋巴细胞比值与糖尿病酮症酸中毒严重程度的相关性研究

Correlation between Neutrophil/lymphocyte Ratio and Severity of Diabetic Ketoacidosis

目的:探讨中性粒细胞/淋巴细胞比值(NLR)与糖尿病酮症酸中毒(DKA)严重程度的相关性。方法:回顾性分析2019年2月-2023年2月于南京医科大学附属江宁医院住院治疗的66例DKA患者的临床资料,根据严重程度将患者分为轻度组(21例)、中度组(24例)及重度组(21例)。比较三组患者在临床资料及实验室检查指标的差异。采用Spearman非参数相关性分析评估NLR与DKA严重程度的相关性。采用受试者工作特征(ROC)曲线评估NLR对DKA严重程度的预判能力。比较不同严重程度DKA患者治疗前后NLR水平差异。结果:三组患者在年龄、糖尿病类型、合并感染比率、心率、呼吸频率、入院随机血糖、CO_(2)结合力、白细胞计数、中性粒细胞计数、NLR、C反应蛋白、血肌酐、D二聚体具有显著性差异(P<0.05)。NLR与DKA严重程度呈正相关(r=0.499,P<0.05)。ROC曲线分析NLR对DKA严重程度的预测价值,ROC-AUC为0.756(95%CI 0.6210.890)。DKA患者治疗后NLR水平显著低于治疗前(P<0.05)。结论:NLR与DKA严重程度相关,可作为早期识别DKA严重程度的简单易行的临床指标。

Objective:To investigate the correlation of neutrophil/lymphocyte ratio(NLR)with severity of diabetic ketoacidosis(DKA).Methods:We retrospectively analyzed the clinical data of 46 patients with diabetic ketoacidosis from the Affiliated Jiangning Hospital of Nanjing Medical University from February 2019 to February 2023,including 21 mild cases,24 moderate cases and 21 severe cases.The clinical manifestations and laboratory test results were compared between the three groups.Spearman nonparametic correla-tion analysis was used to evaluate the correlation between NLR and NLR for severity of DKA.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of NLR for severity of DKA.The NLR levels of DKA patients with different severity were compared before and after treatment.Results:The differences of age,diabetes type,infection rate,heart rate,respiratory rate,random blood glucose,CO_(2)combining power,white blood cell,neutrophil count,NLR,C-reactive protein,serum creatinine and D-Dimer among different DKA subgroups were statisyically significant(P<0.05).NLR had a positive relationship with severity of DKA(r=0.499,P<0.05).In the ROC curve,the AUC of NLR was 0.756(95%CI 0.6210.890).NLR of DKA patients after treatment was significantly lower than that before treatment(P<0.05).Conclusion:NLR correlated with severity of DKA and can be a simple and practical clinical indicator for early identification of DKA severity.