平均红细胞体积、中性粒细胞/淋巴细胞比值、血红蛋白水平联合检测对早期糖尿病肾病的诊断价值  

Diagnostic Value of MCV,NLR and Hb Combined Detection in Early Diabetic Nephropathy

作　　者：冉丹[1] RAN Dan(Clinical Laboratory,Nanyang Second General Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市第二人民医院检验科,河南南阳473000

出　　处：《罕少疾病杂志》2025年第4期93-95,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨外周血平均细胞体积(MCV)、中性粒细胞与淋巴细胞比值(NLR)、血红蛋白(Hb)联合检测对早期糖尿病肾病(DN)的诊断价值。方法回顾性选取2021年3月至2023年6月于本院诊治的早期DN患者82例(设为DN组)、单纯2型糖尿病(T2DM)患者82例(设为T2DM组)进行回顾性分析,另选取健康志愿者41例作为对照组。比较3组外周血MCV、NLR、Hb水平及DN相关生化指标[血尿素氮(BUN)、血肌酐(Scr)、尿酸、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、淀粉样蛋白A(AA)]。分析外周血MCV、NLR、Hb水平与DN相关生化指标相关性。采用受试者工作特征曲线(ROC)分析外周血MCV、NLR、Hb对DN的诊断价值。以肾组织活检为“金标准”,对比分析外周血MCV、NLR、Hb单项及联合对DN的诊断效能,并分析其与病理结果的一致性。结果DN组MCV、Hb水平低于T2DM组、对照组,NLR高于T2DM组、对照组,且T2DM组、对照组比较差异有统计学意义(P<0.05);MCV、Hb与BUN、Scr、尿酸呈负相关,而NLR与之相反(P<0.05);MCV、NLR、Hb联合诊断DN的AUC大于单项指标诊断(P<0.05);MCV、NLR、Hb联合诊断DN的准确率高于单项指标诊断(P<0.05),且联合诊断结果与肾活检检查结果具有高度一致性(Kappa=0.688,P<0.05)。结论MCV、NLR、Hb对早期DN具有一定诊断价值,且联合检测可提高诊断准确率。Objective To investigate the diagnostic value of peripheral blood mean cell volume(MCV),neutrophil to lymphocyte ratio(NLR)and hemoglobin(Hb)in early diabetic nephropathy(DN).Methods A total of 82 patients with early DN(DN group)and 82 patients with type 2 diabetes mellitus(T2DM group)who were treated in our hospital from March 2021 to June 2023 were selected for retrospective analysis,and 41 healthy volunteers were selected as control group.The levels of MCV,NLR,Hb and DN-related biochemical indices[blood urea nitrogen(BUN),serum creatinine(Scr),uric acid,neutrophic granulocyte gelatinase-associated lipid carrier protein(NGAL),amyloid A(AA)]in peripheral blood of the 3 groups were compared.The correlation between the levels of MCV,NLR,Hb and DN in peripheral blood was analyzed.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of MCV,NLR and Hb in peripheral blood for DN.Taking renal tissue biopsy as the"gold standard",the diagnostic efficacy of MCV,NLR and Hb in peripheral blood was compared and their consistency with pathological results was analyzed.Results The levels of MCV and Hb in DN group were lower than those in T2DM group and control group,and NLR was higher than those in T2DM group and control group,and the difference between T2DM group and control group was statistically significant(P<0.05).MCV and Hb were negatively correlated with BUN,Scr and uric acid,while NLR was opposite(P<0.05).The AUC of combined diagnosis of DN by MCV,NLR and Hb was higher than that by single index(P<0.05).The accuracy of the combined diagnosis of DN by MCV,NLR and Hb was higher than that by single index(P<0.05),and the combined diagnosis results were highly consistent with the results of kidney biopsy(Kappa=0.688,P<0.05).Conclusion MCV,NLR and Hb have certain diagnostic value in early DN,and the combined detection can improve the diagnostic accuracy.

关 键 词：糖尿病肾病 平均细胞体积 中性粒细胞与淋巴细胞比值 血红蛋白 诊断 

分 类 号：R587.2[医药卫生—内分泌]