下肢动脉硬化闭塞症患者有无合并2型糖尿病与炎症指标的相关性

Correlation between inflammatory markers and type 2 diabetes in patients with arteriosclerosis obliterans

关键词:  C反应蛋白  中性粒细胞/淋巴细胞比值  下肢动脉硬化闭塞症  2型糖尿病

Key words:  C-reaction protein  neutrophil-to-lymphocyte ratio  arteriosclerosis obliterans  type 2 diabetes mellitus

摘要:

目的分析炎症指标Ｃ反应蛋白（C-reactive protein, CRP）、中性粒细胞/淋巴细胞比值（neutrophil-to-lymphocyte ratio, NLR）与下肢动脉硬化闭塞症（arteriosclerosis obliterans, ASO）有无合并2型糖尿病（type 2 diabetes mellitus, T2DM）患者之间的相关性及临床诊断价值。方法选取ASO患者106名，分为A组（不合并T2DM，n=40）及B组（合并T2DM，n=66）。用Logistic回归分析确定ASO合并T2DM患者的危险因素，应用ROC曲线评估CRP和NLR的诊断价值。结果B组的CRP、NLR水平显著均高于A组，差异有统计学意义（P<0.05）。单因素Logistic回归分析结果表明，纤维蛋白原、平均血红蛋白量、中性粒细胞绝对值、CRP、NLR、前白蛋白、白球比例均为ASO合并T2DM患者的危险因素；多因素Logistic回归分析结果表明，CRP最具有诊断预测价值。相关性分析显示，NLR和CRP的相关性最显著（r=0.803，P<0.001)。ROC曲线结果显示，CRP水平曲线下面积为0.687（95%CI： 0.583~0.792），NLR水平曲线下面积为0.659（95%CI： 0.552~0.767），均对ASO合并T2DM患者具有明确诊断价值（P＜0.01）。结论CRP、NLR是ASO合并T2DM患者的危险因素，具有一定的临床诊断价值。

Abstract:

ObjectiveTo analyze the association between C-reactive protein(CRP) , neutrophil-to-lymphocyte ratio(NLR) and type 2 diabetes mellitus(T2DM) in patients with arteriosclerosis obliterans(ASO). MethodsOne hundred and six patients with ASO were enrolled， including 40 cases without diabetes(non-T2DM group）and 66 cases complicated with diabetes（T2DM group）. Logistic regression analysis was used to determine the risk factors of T2DM in ASO patients, and ROC curve was used to evaluate the diagnostic value of CRP and NLR. ResultsThe levels of CRP and NLR in T2DM group were significantly higher than those in non-T2DM group（P<0.05）. Single factor Logistic regression analysis showed that fibrinogen, mean hemoglobin, absolute value of neutrophils, CRP, NLR, prealbumin and white blood cell ratio were all risk factors for ASO patients with T2DM.Multivariate Logistic regression analysis showed that CRP was the most diagnostic and predictive value. Correlation analysis showed that the correlation between NLR and CRP was the most significant(r=0.803,P<0.001). The area under the ROC curve of CRP and NLR for predicting T2DM in ASO patients was 0.687（95%CI： 0.583-0.792） and 0.659（95%CI： 0.552-0.767）, both of which had definite diagnostic value for ASO patients with T2DM(P<0.01). ConclusionCRP and NLR are the risk factors of ASO patients with T2DM and have certain clinical diagnostic value.