血浆D-二聚体血清同型半胱氨酸及胱抑素C对2型糖尿病并发周围神经病变的检测价值

Detection value of plasma D-dimer and serum Hcy and Cys-C in patients with type 2 diabetes mellitus and peripheral neuropathy

目的探讨血浆D-二聚体(D-D)、血清同型半胱氨酸(Hcy)及胱抑素C(Cys-C)在2型糖尿病(T_(2)DM)并发周围神经病变(DPN)患者中的检测价值。方法回顾性分析2022年1月至2023年6月江西省赣州市赣县区人民医院收治的65例T_(2)DM患者临床资料,依据是否合并DPN分成病变组(31例)与未病变组(34例)。比较2组患者血浆D-D、血清Hcy及Cys-C水平,评估上述指标对T_(2)DM并发DPN的诊断价值。将病变组依据疾病严重程度分成轻度组、中度组与重度组,采用Spearman相关性分析血浆D-D、血清Hcy及血清Cys-C水平与疾病严重程度的关系。结果病变组血浆D-D、血清Hcy及Cys-C水平均高于未病变组,差异有统计学意义(P<0.05),血浆D-D对T_(2)DM并发DPN的诊断敏感度、特异度及曲线下面积(AUC)分别为58%、88%、0.769,血清Hcy对T_(2)DM并发DPN的诊断敏感度、特异度及AUC分别为71%、74%、0.721,血清Cys-C对T_(2)DM并发DPN的诊断敏感度、特异度及AUC分别为74%、79%、0.835。中度组血浆D-D、血清Hcy及血清Cys-C水平高于轻度组,重度组血浆D-D、血清Hcy及血清Cys-C水平高于中度组,且3组间比较差异均有统计学意义(P<0.05),Spearman相关性分析显示,D-D、血清Hcy及血清Cys-C与T_(2)DM并发DPN的疾病严重程度均呈正相关(r=0.585,0.024,0.089,P<0.05)。结论血浆D-D、血清Hcy及Cys-C水平在T_(2)DM并发DPN患者中表达水平较高,且表达水平与患者病情呈正相关,检测上述指标能辅助疾病的诊断。

Objective To investigate the detection value of plasma D-dimer(D-D)and serum homocysteine(Hcy)and cystatin C(Cys-C)in patients with type 2 diabetes mellitus(T_(2)DM)and peripheral neuropathy(DPN).Methods The clinical data of 65 patients with T_(2)DM admitted to Ganxian District People′s Hospital from January 2022 to June 2023 were analyzed retrospectively.The patients were divided into a DPN group(n=31)and a non-DPN group(n=34)according to the presence or absence of DPN.The levels of plasma DD,serum Hcy and serum Cys-C in the two groups were compared.The diagnostic value of the above indicators for T_(2)DM complicated with DPN was evaluated.Patients in the DPN group were divided into mild group,moderate group,and severe group according to severity.Spearman correlation analysis was conducted to discuss the relationship between plasma D-D,serum Hcy and serum Cys-C levels and the severity of the disease.Results The levels of plasma D-D,serum Hcy and serum Cys-C in the DPN group were higher than those in the non-DPN group(P<0.05).The sensitivity,specificity and AUC of plasma D-D for diagnosing T_(2)DM complicated with DPN were 58%,88%and 0.769.The diagnostic sensitivity,specificity and AUC of serum Hcy were 71%,74%and0.721.The diagnostic sensitivity,specificity and AUC of serum Cys-C were 74%,79%and 0.835.The levels of plasma D-D,serum Hcy and serum Cys-C increased in sequence from the mild group,the moderate group to the severe group,with statistically significant differences between groups(P<0.05).The spearman correlation analysis found that D-D,serum Hcy and serum Cys-C were positively correlated with the severity of DPN in T_(2)DM(r=0.585,0.024,0.089,P<0.05).Conclusion The levels of plasma D-D,serum Hcy and serum Cys-C are elevated in patients with T_(2)DM complicated with DPN,and the levels are positively correlated with the patients's condition.Detecting these indicators can assist in the diagnosis of the disease.