血清HCY和NLR在2型糖尿病肾病中的诊断价值研究

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。

Diagnostic value of serum HCY and NLR in type 2 diabetic nephropathy

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%and 67.44%, 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.