| 糖尿病并发新型冠状病毒肺炎患者临床实验室常规检测指标变化及应用价值研究 |
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| 引用本文： | 胡天喜a,闫 彬a,陶林静a,叶亚平a,夏盼盼b.糖尿病并发新型冠状病毒肺炎患者临床实验室常规检测指标变化及应用价值研究[J].现代检验医学杂志,2022,0(3):132-137. |
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| 作者姓名： | 胡天喜a 闫 彬a 陶林静a 叶亚平a 夏盼盼b |
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| 作者单位： | （南阳市中心医院a. 医学检验科；b. 感染性疾病科，河南南阳 473000） |
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| 摘 要： | 目的 探讨糖尿病并发新型冠状病毒肺炎（ corona virus disease 2019，COVID 19）患者的临床常规实验室指标变化及其临床意义。方法 收集 2020年 1月 21日～ 3月 2日在河南省南阳市中心医院感染性疾病科就诊的 COVID 19患者，分为糖尿病（diabetes mellitus，DM）组和非糖尿病（non-diabetes mellitus，NDM）组，采用 Mann-Whitney U检验和 Kruskal-Wallis H检验比较组间常规检测指标的差异，并用 Logistic回归对重症患者进行危险因素分析。结果 ①共有 NDM组 36例，DM组 17例，DM组的年龄显著高于 NDM组（59.12±10.92 岁 vs 45.03±16.73岁），差异具有统计学意义（ t=3.31，P=0.001）；②与 NDM组相比， DM组的中性粒细胞计数 （5.85±3.29 ）×109/L]，纤维蛋白原浓度（4.71±1.37 g/L），D-二聚体 0.63（0.22，2.81) mg/L ] ,C反应蛋白 18.30（12.81，54.10）mg/L]和白细胞介素 -4（2.55± 0.49pg/ml）水平显著高于 NDM组 （3.41±1.93）×109/L，3.54±0.82 g/L，0.22(0.16，0.39) mg/L，8.05(1.59，16.45）mg/L，（2.01±0.63pg/ml）]，差异均有统计学意义（ t=2.45～ 3.40，均 P ＜ 0.05），而淋巴细胞计数显著低于 NDM组 （0.83±0.45）×109/L vs（1.32±0.50）×109/L]，差异有统计学意义（ t=-3.42，P=0.001）；③随着血糖水平的升高， COVID-19患者的淋巴细胞计数逐渐降低 （1.50±0.41）×109/L，（1.19±0.55 ）×109/L，（0.78±0.33）×109/L]，差异有统计学意义（ F=13.93，P=0.001），而纤维蛋白原浓度（ 3.24±0.54 g/L，3.90±0.98 g/L，4.63±1.53 g/L）、 D-二聚体 0.16（0.12，0.42）mg/L， 0.27（0.16， 0.44）mg/L，0.63（0.22，2.81）mg/L ]和 C反应蛋白 5.10（1.58， 10.84）mg/L，9.40（2.80，28.40）mg/L，27.93（12.81，64.39）mg/L]水平逐渐升高，差异有统计学意义（ F=9.30～ 13.32，均 P＜ 0.05）；④ DM组患重症（包括重型和危重型） COVID-19的比例显著高于 NDM组（58.80% vs 16.67%），差异有统计学意义（ χ2=0.43，P=0.002），且住院时间显著长于 NDM患者（15.18±5.43天 vs 10.39±5.82天），差异有统计学意义（ t=2.87，P=0.004）。调整性别和年龄后发现，淋巴细胞计数（风险比 HR]=0.023，P=0.011）、糖尿病（ HR=5.33， P=0.026）是 COVID-19患者罹患重症的独立危险因素。结论 糖尿病并发 COVID-19患者处于高凝状态，炎症反应更显著，糖尿病是 COVID-19患者罹患重症的独立危险因素。
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| 关 键 词： | 新型冠状病毒肺炎 糖尿病 实验室检测 |
Changes and Application Value of Clinical Laboratory Routine Testing Indicators in Patients with Diabetes Mellitus Complicated with Corona Virus Disease 2019 |
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| HU Tian-xia,YAN Bina,TAO Lin-jinga,YE Ya-pinga,XIA Pan-panb.Changes and Application Value of Clinical Laboratory Routine Testing Indicators in Patients with Diabetes Mellitus Complicated with Corona Virus Disease 2019[J].Journal of Modern Laboratory Medicine,2022,0(3):132-137. |
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| Authors: | HU Tian-xia YAN Bina TAO Lin-jinga YE Ya-pinga XIA Pan-panb |
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| Affiliation: | (a.Department of Laboratory Medicine；b.Department of Infectious Diseases, Nanyang Central Hospital, Henan Nanyang 473000, China) |
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| Abstract: | Objective To explore the clinical routine laboratory changes and their clinical significance in patients with diabetes mellitus complicated with corona virus disease 2019 (COVID-19). Methods The test data of COVID-19 patients were collected from January 21st to March 2nd, 2020 in the Department of Infectious Diseases, Nanyang Central Hospital of Henan Province. The patients were divided into a Diabetes Mellitus (DM) group and a non-Diabetes Mellitus (NDM) group. Mann-Whitney U test and Kruskal-Wallis H test were used to compare the differences between the two groups, and Logistic regression analysis was used to analyze the risk factors of severe patients. Results ① There were 36 cases in the non-DM group and 17 cases in the DM group. The age of the DM group was significantly higher than that of the non-DM group (59.12±10.92 years vs 45.03±16.73 years), the difference was statistically significant (t=3.31, P=0.001). ② The neutrophil count（5.85±3.29）×109/L], FIB （4.71± 1.37 g/L）, D-dimer 0.63（0.22，2.81) mg/L], C-reactive protein 18.30（12.81，54.10）mg/L] and interleukin-4 levels（ 2.55±0.49 pg/ml）of the DM group were significantly higher than those in the non-DM group（3.41±1.93）×109/L，3.54±0.82 g/L， 0.22(0.16，0.39) mg/L，8.05(1.59，16.45）mg/L，2.01±0.63pg/ml]，the differences were statistically significant （t=2.45 ~ 3.40， all P ＜ 0.05）, while the lymphocyte count was significantly lower than those of the non-DM group（0.83±0.45）×109/L vs （1.32±0.50）×109/L]，the difference was statistically significant（t=-3.42，P=0.001）. ③ With the increase of blood glucose levels, the lymphocyte count （1.50±0.41）×109/L,（1.19±0.55）×109/L,（0.78±0.33）×109/L] of COVID-19 patients gradually decreased, while FIB （3.24±0.54 g/L，3.90±0.98 g/L，4.63±1.53 g/L）, D-dimer 0.16（0.12，0.42） mg/L，0.27（0.16，0.44）mg/L，0.63（0.22，2.81）mg/L] and C-reactive protein 5.10（1.58，10.84）mg/L，9.40（2.80， 28.40）mg/L，27.93（12.81，64.39）mg/L] levels gradually increased ，the differences were statistically significant（F=9.30 ~ 13.93，respectively，all P ＜ 0.05）. ④ The proportion of severe COVID-19(58.80% vs 16.67%) and hospital stay（15.18±5.43 day vs 10.39±5.82 day）in the DM group were significantly higher than that of the non-DM group, the differences were statistically significant（χ2=0.43, P=0.002；t=2.87, P=0.004）. After adjusting for gender and age, lymphocyte count (hazard ratio HR]=0.023, P=0.011) and diabetes (HR=5.33, P=0.026) were independent risk factors for severe COVID-19 patients. Conclusion COVID-19 patients with diabetes were in a hypercoagulable state, and the inflammatory response was more pronounced. Individualized hypoglycemic therapy should be implemented for them. |
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