甲状腺功能、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值与糖尿病酮症酸中毒相关性的研究

Correlation between thyroid function,NLR,PLR and diabetic ketoacidosis

目的 探讨甲状腺功能、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)与DKA的相关性。方法 选取2021年1月至2024年3月于安徽省第二人民医院内分泌科收治的DM患者272例,分为DKA组(n=74)、糖尿病酮症组(DK组,n=100)、单纯DM组(n=98)。比较各组血清游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、FPG、Hb A1c、阴离子间隙(AG)、白细胞(WBC)、中性粒细胞(N)、血小板(PLT)、淋巴细胞(L),并计算NLR、PLR。Logistic回归分析DKA的影响因素,受试者工作特征(ROC)曲线评估FT3、NLR和PLR对DKA的诊断价值。结果 DKA组住院天数、FPG、Hb A1c、低T3综合征发生率、AG、WBC、N、PLT、NLR、PLR高于DM、DK组(P<0.05),年龄、FT3、FT4、TSH、L低于DM、DK组(P<0.05)。Logistic回归分析显示,FT3、AG、NLR、PLR是DKA的影响因素。ROC曲线分析显示,FT3、NLR、PLR及联合检测预测DKA的曲线下面积分别为0.961、0.938、0.810、0.980,敏感度为87.8%、90.5%、75.7%、98.6%,特异度为95.5%、92.9%、76.3%、92.4%,联合检测优于单一检测。结论 FT3、NLR、PLR与DKA发生相关,有一定诊断价值,联合检测诊断价值较高,可为临床诊断DKA提供参考。

Objective To investigate the correlation between thyroid function,neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and diabetic ketoacidosis(DKA).Methods A total of 272 diabetic patients admitted to the Department of Endocrinology,Anhui No.2 Provincial People’s Hospital were enrolled in this study from January 2021 to March 2024 and divided into DKA group(n=74),diabetic ketosis group(DK group,n=100)and simple DM group(n=98)according to their disease conditions.Serum free triiodothyronine(FT3),free tetraiodothyronine(FT4),thyroid stimulating hormone(TSH),FPG,HbA1c,anion gap(AG),white blood cells(WBC),neutrophils(N),platelets(PLT)and lymphocytes(L)were detected in each group,and NLR and PLR were calculated.The influence factors of DKA were analyzed by logistic regression,and the diagnostic value of FT3,NLR and PLR in DKA was evaluated by receiver operating characteristic(ROC)curve.Results Hospitalization days,FPG,HbA1c,incidence of LT3S,AG,WBC,N,PLT,NLR,PLR were higher in DKA group than in DM and DK groups(P<0.05),Age,FT3,FT4,TSH,L were lower in DKA group than in DM and DK groups(P<0.05)Logistic regression analysis showed that FT3,AG,NLR and PLR were the influencing factors for DKA.ROC curve showed that the area under the curve of FT3,NLR,PLR and combined detection to predict DKA were 0.961,0.938,0.810 and 0.980,the sensitivity was 87.8%,90.5%,75.7%and 98.6%,the specificity was 95.5%,92.9%,76.3%,92.4%,and the combined detection was superior to the single detection.Conclusions FT3,NLR,PLR have a certain diagnostic value for DKA,and the combined detection of the three has a high diagnostic value,which can provide a reference for clinical diagnosis of DKA.