血小板与淋巴细胞比值对糖尿病神经源性膀胱的诊断价值

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1177 KB)
输出: BibTeX | EndNote (RIS)

摘要目的分析血小板与淋巴细胞比值(PLR),以及中性粒细胞与淋巴细胞比值(NLR)对糖尿病神经源性膀胱的诊断价值。方法回顾性分析2019-01至2022-12在第909医院诊断为糖尿病神经源性膀胱138例患者和单纯2型糖尿病患者307例临床资料。采用logistic回归分析糖尿病神经源性膀胱发生的独立危险因素。使用受试者工作特征曲线(ROC)分析危险因素诊断糖尿病神经源性膀胱效能。结果与单纯糖尿病组相比,糖尿病神经源性膀胱组的女性比例高、年龄大、糖尿病史时间长, 合并有糖尿病肾病、动脉粥样硬化比例均高,空腹血糖水平、PLR、NLR、血尿素氮水平高;而BMI、吸烟史、饮酒史比例红细胞、血红蛋白水平、总胆红素、直接胆红素、间接胆红素、白蛋白、尿酸水平低(P<0.05)。糖尿病史时间长[OR=1.127,95%CI(1.037~1.223),P=0.003]、PLR升高[OR=1.408,95%CI(1.130~1.753),P=0.001]是糖尿病神经源性膀胱发生独立危险因素,总胆红素[OR=0.881,95%CI(0.792~0.979),P=0.021]和血红蛋白[OR=0.956,95%CI(0.924~0.988),P=0.007]降低是其保护因素。ROC曲线分析示,PLR的曲线下面积最大为0.897,最佳诊断切点为101.19,此时敏感度和特异度分别为83.3%和76.6%。结论糖尿病神经源性膀胱患者的PLR、NLR值较单纯糖尿病患者更高。PLR对糖尿病人群中发生神经源性膀胱具有一定诊断价值。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	方晓燕
	曾炎河
	林小英
	林正坤
	何素玲
	阮兢

关键词 ：糖尿病, 神经源性膀胱, 炎症, 血小板, 淋巴细胞

Abstract：Objective To analyze the relationship between the value of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) in the diagnosis of diabetic neurogenic bladder. Methods The clinical data of 138 patients with diabetic neurogenic bladder and 307 patients with type 2 diabetes mellitus diagnosed in the 909th Hospital from January 2019 to December 2022 were retrospectively analyzed. Logistic regression was used to analyze the independent risk factors for diabetic neurogenic bladder development. The receiver operating characteristic curve (ROC) was used to analyze the risk factors to the diagnostic efficacy of diabetic neurogenic bladder. Results Compared with the simple diabetes mellitus group, the diabetic neurogenic bladder group had a higher proportion of women, older age, a longer history of diabetes, a higher proportion of diabetic nephropathy and atherosclerosis, and a higher level of fasting blood glucose, PLR, NLR and blood urea nitrogen. The proportion of BMI, smoking history and drinking history was lower, and the levels of erythrocyte, hemoglobin, total bilirubin, direct bilirubin, indirect bilirubin, albumin and uric acid were even lower (P<0.05). Long history of diabetes [OR=1.127, 95% CI(1.037-1.223), P=0.003]and an elevated PLR [OR=1.408, 95% CI(1.130-1.753),P=0.001] were independent risk factors for diabetic neurogenic bladder development, while low levels of total bilirubin [OR=0.881, 95% CI(0.792-0.979),P=0.021] and decreased hemoglobin [OR=0.956, 95% CI(0.924-0.988),P=0.007] were protective factors. The result of ROC showed that the maximum area under the curve of PLR was 0.897, and the best diagnostic cut point was 101.19, at which time the sensitivity and specificity were 83.3% and 76.6% respectively. Conclusions PLR and NLR values of patients with diabetic neurogenic bladder are higher than those of patients with diabetes mellitus alone. PLR is valuable in the diagnosis of neurogenic bladder in diabetic patients.

Key words： diabetes mellitus neurogenic bladder inflammation platelet lymphocyte

收稿日期: 2023-10-16

ZTFLH:

R587.2

基金资助:漳州市自然科学基金项目(ZZ2020J03);军队某课题资助

通讯作者: 阮兢,E-mail:ruanjing81@hotmail.com

作者简介: 方晓燕,本科学历,主治医师。

引用本文:

方晓燕, 曾炎河, 林小英, 林正坤, 何素玲, 阮兢. 血小板与淋巴细胞比值对糖尿病神经源性膀胱的诊断价值[J]. 武警医学, 2024, 35(6): 493-496. FANG Xiaoyan, ZENG Yanhe, LIN Xiaoying, LIN Zhengkun, HE Suling, RUAN Jing. Value of platelet to lymphocyte ratio in diagnosis of diabetic neurogenic bladder. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(6): 493-496.

链接本文:

https://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 https://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2024/V35/I6/493

[1]	中华医学会糖尿病学分会神经并发症学组. 糖尿病神经病变诊治专家共识(2021年版)[J]. 中华内分泌代谢杂志, 2021, 37(6):499-515.
[2]	Erdogan B R, Liu G, Arioglu-Inan E, et al. Established and emerging treatments for diabetes-associated lower urinary tract dysfunction[J]. Naunyn Schmiedebergs Arch Pharmacol, 2022, 395(8):887-906.
[3]	彭茜, 李舍予, 安振梅, 等. 美国泌尿协会症状指数评分在女性2型糖尿病神经性膀胱患者中的应用价值研究[J]. 四川大学学报(医学版), 2019, 50(4):566-570.
[4]	中华医学会糖尿病学分会神经并发症学组. 糖尿病神经病变诊治专家共识(2021年版)[J]. 中华糖尿病杂志, 2021, 13(6):540-557.
[5]	潘红霞, 熊峰, 张建梅, 等. 不同病因神经源性膀胱患者尿动力检查的结果比较和分析[J]. 中华物理医学与康复杂志, 2021, 43(7):642-644.
[6]	Rohm T V, Meier D T, Olefsky J M, et al. Inflammation in obesity, diabetes, and related disorders[J]. Immunity, 2022, 55(1):31-55.
[7]	Ellulu M S, Samouda H. Clinical and biological risk factors associated with inflammation in patients with type 2 diabetes mellitus[J]. BMC Endocr Disord, 2022, 22(1):16.
[8]	左源渊, 辛丽娟. 血清趋化因子CXCL12、CXCL17与2型糖尿病患者微血管病变的关系[J]. 分子诊断与治疗杂志, 2022, 14(12):2072-2076.
[9]	赵之标, 毕明宏, 李国祥. 非小细胞肺癌免疫治疗前后NLR和PLR变化及对免疫治疗疗效的预测价值[J]. 现代肿瘤医学, 2022, 30(4):613-618.
[10]	Portale G, Bartolotta P, Azzolina D, et al. Prognostic role of platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte, and lymphocyte-to-monocyte ratio in operated rectal cancer patients: systematic review and meta-analysis[J].Langenbecks Arch Surg, 2023, 408(1):85.
[11]	Zeng J, Chen M, Feng Q, et al. The platelet-to-lymphocyte ratio predicts diabetic retinopathy in type 2 diabetes mellitus[J].Diabetes Metab Syndr Obes, 2022, 15:3617-3626.
[12]	赵海燕, 张慧莉, 汪晓妹, 等. 阿托伐他汀对老年2型糖尿病合并骨质疏松患者血清Hb、NLR、PLR及骨代谢指标的影响[J]. 疑难病杂志, 2022, 21(12):1242-1247.
[13]	Hughes F M Jr, Odom M R, Cervantes A, et al. Inflammation triggered by the NLRP3 inflammasome is a critical driver of diabetic bladder dysfunction[J]. Front Physiol, 2022, 13:920487.
[14]	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志, 2021, 13(4): 315- 409.
[15]	Wang C C, Kuo H C. Urothelial dysfunction and chronic inflammation in diabetic patients with overactive bladder[J]. Low Urin Tract Symptoms, 2017, 9(3):151-156.
[16]	Berbudi A, Rahmadika N, Tjahjadi A I, et al. Type 2 diabetes and its impact on the immune system[J]. Curr Diabetes Rev, 2020, 16(5):442-449.
[17]	Inouye B M, Hughes F M Jr, Jin H, et al. Diabetic bladder dysfunction is associated with bladder inflammation triggered through hyperglycemia, not polyuria[J]. Res Rep Urol, 2018, 10:219-225.
[18]	骆佳铭, 李机, 赵伟. 氧化应激介导的DNA损伤在大鼠心肌H9C2细胞缺氧/复氧损伤中的作用[J]. 重庆医学, 2021, 50(12):1993-1997.
[19]	Daenen K, Andries A, Mekahli D, et al. Oxidative stress in chronic kidney disease[J]. Pediatr Nephrol, 2019, 34(6):975-991.
[20]	钟宏文, 朱丽康, 谢席平, 等. 外周血NLR、PLR在2型糖尿病周围神经病变辅助诊断中应用价值[J]. 实验与检验医学, 2023, 41(1):63-66.
[21]	Hudzik B, Szkodzinski J, Gorol J, et al. Platelet-to-lymphocyte ratio is a marker of poor prognosis in patients with diabetes mellitus and ST-elevation myocardial infarction[J]. Biomark Med, 2015, 9(3):199-207.
[22]	Zhang K, Ding S, Lyu X, et al. Correlation between the platelet-to-lymphocyte ratio and diabetic foot ulcer in patients with type 2 diabetes mellitus[J]. J Clin Lab Anal, 2021, 35(4):e23719.
[23]	刘晓倩, 傅莉萍, 王保法, 等. 血清同型半胱氨酸、胱抑素C、胆红素水平与2型糖尿病伴慢性肾脏病的相关性探讨[J]. 浙江临床医学, 2022, 24(8):1133-1135.
[24]	闫明鑫, 赵豆豆, 宛惠玲, 等. 孕早期血红蛋白水平与妊娠期糖尿病的关系研究:基于出生人口队列[J]. 中华疾病控制杂志, 2023, 27(1):60-64, 76.
[25]	Song Y, Zhao Y, Shu Y, et al. Combination model of neutrophil to high-density lipoprotein ratio and system inflammation response index is more valuable for predicting peripheral arterial disease in type 2 diabetic patients: A cross-sectional study[J]. Front Endocrinol (Lausanne), 2023, 14:1100453.
[26]	Chen Y, Chai Q, Wang Q, et al. Neutrophil-to-lymphocyte ratio is associated with coronary microvascular dysfunction in type 2 diabetes mellitus patients[J]. Diabetes Res Clin Pract, 2021, 178:108983.