血清HCY和NLR在2型糖尿病肾病中的诊断价值研究
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摘要
目的利用受试者工作特征曲线(ROC曲线)评价血清同型半胱氨酸(HCY)、中性粒细胞/淋巴细胞比值(NLR)及其联合诊断在2型糖尿病肾病中的诊断价值。方法随机选取2016年6月—2018年6月本院收治的2型糖尿病患者100例,根据临床诊断分为糖尿病肾病组43例和糖尿病组57例,记录2组患者性别、年龄等基线资料以及血清HCY、NLR检测结果。结果糖尿病肾病组血清HCY、NLR水平均明显高于糖尿病组,差异有统计学意义(P<0.05)。其中,血清HCY、NLR以及联合试验诊断糖尿病肾病ROC曲线下面积分别为0.782、0.635、0.793,灵敏度分别为79.07%、51.16%、67.44%,特异度分别为68.42%、64.91%、89.47%。Z检验结果显示,血清HCY诊断糖尿病肾病ROC曲线下面积大于NLR(P<0.05),联合试验诊断糖尿病肾病ROC曲线下面积大于NLR(P<0.05),HCY诊断糖尿病肾病ROC曲线下面积与联合试验差异无统计学意义(P>0.05)。结论血清HCY在2型糖尿病肾病中的诊断价值高于NLR,尚未发现二者联合试验能够提高其诊断价值。
Objective To evaluate the diagnostic value of serum homocysteine(HCY)and neutrophil/lymphocyte ratio(NLR)and their combined tests in type 2 diabetic nephropathy.Methods From June 2016 to June 2018,100 patients with type 2 diabetes were randomly selected.According to clinical diagnosis,43 patients with diabetes nephropathy and 57 patients with diabetes were enrolled.The data such as gender and age,and serum HCY and NLR were registered in two groups.Results The serum levels of HCY and NLR in the diabetic nephropathy group were significantly higher than those in the diabetic group(P<0.05).The areas under the receiver operating characteristic(ROC) curve of serum Hcy,NLR and combined tests for diagnosis of diabetic nephropathy were 0.782,0.635,and 0.793,the sensitivitieswere 79.07%,51.16%and67.44%,and the specificities were 68.42%,64.91%and 89.47%,respectively.The Z test showed that the ROC curve of the serum HCY was higher than that of the serum NLR(P<0.05),the ROC curve of combined tests was higher than that of the serum NLR(P<0.05),but there was no statistically significant difference between the serum HCY and combined tests.(P>0.05).Conclusion The diagnostic value of serum HCY in type 2 diabetic nephropathy is better than that of NLR.It has not been found that the combined tests can improve its diagnostic value.
Objective To evaluate the diagnostic value of serum homocysteine(HCY)and neutrophil/lymphocyte ratio(NLR)and their combined tests in type 2 diabetic nephropathy.Methods From June 2016 to June 2018,100 patients with type 2 diabetes were randomly selected.According to clinical diagnosis,43 patients with diabetes nephropathy and 57 patients with diabetes were enrolled.The data such as gender and age,and serum HCY and NLR were registered in two groups.Results The serum levels of HCY and NLR in the diabetic nephropathy group were significantly higher than those in the diabetic group(P<0.05).The areas under the receiver operating characteristic(ROC) curve of serum Hcy,NLR and combined tests for diagnosis of diabetic nephropathy were 0.782,0.635,and 0.793,the sensitivitieswere 79.07%,51.16%and67.44%,and the specificities were 68.42%,64.91%and 89.47%,respectively.The Z test showed that the ROC curve of the serum HCY was higher than that of the serum NLR(P<0.05),the ROC curve of combined tests was higher than that of the serum NLR(P<0.05),but there was no statistically significant difference between the serum HCY and combined tests.(P>0.05).Conclusion The diagnostic value of serum HCY in type 2 diabetic nephropathy is better than that of NLR.It has not been found that the combined tests can improve its diagnostic value.
引文
[1]Chen L,Magliano DJ,Zimmet PZ.The worldwide epidemiology of type2 diabetes mellitus-present and future perspectives[J].Nat Rev Endocrinol,2011,8(4):228-236.
[2]王垚,于博,王煜华.血尿酸水平与血浆致动脉粥样硬化指数与2型糖尿病肾病的相关性研究[J].临床内科杂志,2017,34(8):541-544.
[3]李剑波,成玉泽,戴庆,等.血浆同型半胱氨酸水平对于2型糖尿病早期肾病的独立预测意义[J].中华临床医师杂志(电子版):2010,4(5):574-577.
[4]方一凡,李华.老年2型糖尿病NLR、PLR与糖尿病肾病的相关性研究[J].中国实用医刊,2017,44(23):16-19.
[5]中华医学会糖尿病分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-42.
[6]李静,梁田田,王文健.糖尿病肾病的早期诊断[J].中华肾脏病杂志,2017,33(6):470-475.
[7]张志强,袁石文,黄志勇.血清同型半胱氨酸检测在糖尿病肾病中的临床意义[J].现代医院,2012,12(6):80-82.
[8]乔丽丽,李冬娥.血清同型半胱氨酸与2型糖尿病肾病的关系[J].中华全科医学,2011,9(6):874-875.
[9]何雪梅,蒋洪敏.血清同型半胱氨酸、胱抑素C及尿微量白蛋白联合检测在糖尿病早期肾病中的意义[J].实用预防医学,2010,17(1):41-43.
[10]许水良.联合检测血清同型半胱氨酸和尿酸对2型糖尿病肾病早期诊断的价值[J].四川医学,2013,34(9):1431-1434.
[11]申丽红,陈永德,朝浩鹏,等.中性粒细胞/淋巴细胞比值对血流感染的诊断价值[J].基础医学与临床,2017,37(7):1000-1003.
[12]陈星宇,姚辉华,徐荣华,等.中性粒细胞/淋巴细胞比值及局部炎症反应与胃癌预后的关系[J].四川医学,2017,38(10):1120-1123.
[13]Afsar B.The relationship between neutrophil lymphocyte ratio with urinary protein and albumin excretion in newly diagnosed patients with type 2 diabetes[J].Am J Sci,2014,347(3):217-220.
[14]刘清杏,黄金华,李荣东,等.中性粒细胞与淋巴细胞的比值、胰岛素抵抗对早期糖尿病肾病的预测价值[J].广东医学,2016,37(9):1325-1327.
[15]Azab B,Daoud J,Naeem FB,et al.Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients(3-year follow-up study)[J].Ren Fail,2012,34(5):571-576.
[16]朱亚丽,何丽,唐建东,等.2型糖尿病肾病患者中性粒细胞与淋巴细胞比值的临床意义[J].医学与哲学,2016,37(1B):33-34.
[17]余建洪,殷小华,阴益.中性粒细胞/淋巴细胞比值和胱抑素C对2型糖尿病肾病的早期诊断价值[J].蚌埠医学院学报,2018,43(1):87-89.
[2]王垚,于博,王煜华.血尿酸水平与血浆致动脉粥样硬化指数与2型糖尿病肾病的相关性研究[J].临床内科杂志,2017,34(8):541-544.
[3]李剑波,成玉泽,戴庆,等.血浆同型半胱氨酸水平对于2型糖尿病早期肾病的独立预测意义[J].中华临床医师杂志(电子版):2010,4(5):574-577.
[4]方一凡,李华.老年2型糖尿病NLR、PLR与糖尿病肾病的相关性研究[J].中国实用医刊,2017,44(23):16-19.
[5]中华医学会糖尿病分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-42.
[6]李静,梁田田,王文健.糖尿病肾病的早期诊断[J].中华肾脏病杂志,2017,33(6):470-475.
[7]张志强,袁石文,黄志勇.血清同型半胱氨酸检测在糖尿病肾病中的临床意义[J].现代医院,2012,12(6):80-82.
[8]乔丽丽,李冬娥.血清同型半胱氨酸与2型糖尿病肾病的关系[J].中华全科医学,2011,9(6):874-875.
[9]何雪梅,蒋洪敏.血清同型半胱氨酸、胱抑素C及尿微量白蛋白联合检测在糖尿病早期肾病中的意义[J].实用预防医学,2010,17(1):41-43.
[10]许水良.联合检测血清同型半胱氨酸和尿酸对2型糖尿病肾病早期诊断的价值[J].四川医学,2013,34(9):1431-1434.
[11]申丽红,陈永德,朝浩鹏,等.中性粒细胞/淋巴细胞比值对血流感染的诊断价值[J].基础医学与临床,2017,37(7):1000-1003.
[12]陈星宇,姚辉华,徐荣华,等.中性粒细胞/淋巴细胞比值及局部炎症反应与胃癌预后的关系[J].四川医学,2017,38(10):1120-1123.
[13]Afsar B.The relationship between neutrophil lymphocyte ratio with urinary protein and albumin excretion in newly diagnosed patients with type 2 diabetes[J].Am J Sci,2014,347(3):217-220.
[14]刘清杏,黄金华,李荣东,等.中性粒细胞与淋巴细胞的比值、胰岛素抵抗对早期糖尿病肾病的预测价值[J].广东医学,2016,37(9):1325-1327.
[15]Azab B,Daoud J,Naeem FB,et al.Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients(3-year follow-up study)[J].Ren Fail,2012,34(5):571-576.
[16]朱亚丽,何丽,唐建东,等.2型糖尿病肾病患者中性粒细胞与淋巴细胞比值的临床意义[J].医学与哲学,2016,37(1B):33-34.
[17]余建洪,殷小华,阴益.中性粒细胞/淋巴细胞比值和胱抑素C对2型糖尿病肾病的早期诊断价值[J].蚌埠医学院学报,2018,43(1):87-89.