血小板/淋巴比值与糖尿病酮症患者病情严重程度的相关性  

Correlation between Platelet/Lymph Ratio and Disease Severity in Patients with Diabetic Ketosis

作　　者：王伟棋 闵军[1] 马剑清 赵文姣 李炜明[2] WANG Weiqi;MIN Jun;MA Jianqing;ZHAO Wenjiao;LI Weiming(Department of Emergency,Fuzhou Second Hospital,Fuzhou,Fujian Province,350000 China;Department of Orthopedics,Fuzhou Second Hospital,Fuzhou,Fujian Province,350000 China)

机构地区：[1]福州市第二医院急诊科,福建福州350000 [2]福州市第二医院骨科,福建福州350000

出　　处：《糖尿病新世界》2023年第16期10-14,共5页Diabetes New World Magazine

基　　金：福建省创伤骨科急救与康复临床医学研究中心(2020Y2014)。

摘　　要：目的探究血小板/淋巴比值(platelet-to-lymphoccyte ratio,PLR)与糖尿病酮症患者病情严重程度相关性及其在急诊诊治中的作用。方法回顾性分析2020年1月—2022年9月福州市第二医院急诊收治的55例糖尿病酮症患者的临床资料,根据动脉血气分析结果分为病情轻度组(n=23)、中度组(n=20)及重度组(n=12),另选择期无酮症酸中毒的20例2型糖尿病住院患者设为对照组,4组患者在入院时均进行血常规检测,计算PLR,比较4组的PLR、血糖水平、动脉血气分析结果,分析患者PLR与血糖水平、动脉血pH、HCO_(3)^(-)的相关性。结果病情重度组、中度组、轻度组PLR、血糖水平高于对照组,而且病情重度组高于病情中度组、轻度组,动脉血pH、血HCO_(3)^(-)值低于病情中度组、轻度组,差异有统计学意义(P<0.05)。经Pearson分析,糖尿病酮症患者的PLR与血糖呈正相关,与动脉血HCO_(3)^(-)呈负相关(P<0.05)。ROC曲线发现,PLR预测糖尿病酮症病情严重程度的最佳切点值为116.23,敏感度75.00%,特异性72.10%。结论糖尿病酮症患者PLR与代谢性酸中毒严重程度密切相关,故对于糖尿病酮症患者应密切监测PLR变化,为临床制订诊疗方案提供参考依据。Objective To explore the correlation between platelet-to-lymphoccyte ratio(PLR) and the severity of diabetic ketosis and its role in emergency diagnosis and treatment.Methods The clinical data of 55 patients with diabetic ketoacidosis admitted to the emergency department of Fuzhou Second Hospital from January 2020 to September 2022 were retrospectively analyzed.According to the results of arterial blood gas analysis,the patients were divided into mild group(n=23),moderate group(n=20) and severe group(n=12).Another 20 patients with type 2 diabetes mellitus without ketoacidosis were selected as the control group.The four groups of patients were tested for blood routine at admission,and PLR was calculated.The PLR,blood glucose level and arterial blood gas analysis results of the four groups were compared,and the correlation between PLR and blood glucose level,arterial blood pH and HCO_(3)^(-)was analyzed.Results The levels of PLR and blood glucose in the severe group,moderate group and mild group were higher than those in the control group,and the severe group was higher than that in the moderate group and the mild group,and the arterial blood pH and blood HCO_(3)^(-)value were lower than those in the moderate group and the mild group,and the differences were statistically significant(P<0.05).Pearson analysis showed that PLR in patients with diabetic ketosis was positively correlated with blood glucose,and negatively correlated with arterial blood HCO_(3)^(-)(P<0.05).ROC curve showed that the optimal cut-off value of PLR in predicting the severity of diabetic ketosis was 116.23,with a sensitivity of 75.00% and a specificity of 72.10%.Conclusion The platelet/lymphatic ratio is closely related to the severity of metabolic acidosis in patients with diabetic ketosis.Therefore,for patients with diabetic ketosis,the change of platelet/lymphatic ratio should be closely monitored to provide reference for clinical diagnosis and treatment plan.

关 键 词：糖尿病酮症 血小板/淋巴比值 病情严重程度 疗效评估 

分 类 号：R446[医药卫生—诊断学]