[1]赵淑宁,刘向玲,苏绍波,等.单核细胞/淋巴细胞比值、中性粒细胞百分比/白蛋白比值对糖尿病性黄斑水肿的预测价值[J].新乡医学院学报,2024,(1):021-25.[doi:10.7683/xxyxyxb.2024.01.004]
　ZHAO Shuning,LIU Xiangling,SU Shaobo,et al.Predictive value of monocyte to lymphocyte ratio,neutrophil percentage to albumin ratio for diabetic macular edema[J].Journal of Xinxiang Medical University,2024,(1):021-25.[doi:10.7683/xxyxyxb.2024.01.004]
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单核细胞/淋巴细胞比值、中性粒细胞百分比/白蛋白比值对糖尿病性黄斑水肿的预测价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
期数:
2024年1
页码:
021-25
栏目:
临床研究
出版日期:
2024-01-05

文章信息/Info

Title:
Predictive value of monocyte to lymphocyte ratio,neutrophil percentage to albumin ratio for diabetic macular edema
作者:
赵淑宁1; 刘向玲1; 苏绍波2; 吴小清1
(1.新乡医学院第三附属医院眼科,河南　新乡　453003;2.新乡医学院,河南　新乡　453003)
Author(s):
ZHAO Shuning1; LIU Xiangling1; SU Shaobo2; WU Xiaoqing1
(1.Department of Ophthalmology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;2.Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
关键词:
糖尿病性黄斑水肿; 单核细胞/淋巴细胞比值; 中性粒细胞百分比/白蛋白比值
Keywords:
diabetic macular edema; monocyte to lymphocyte ratio; neutrophil percentage to albumin ratio
分类号:
R774.5
DOI:
10.7683/xxyxyxb.2024.01.004
文献标志码:
A
摘要:
目的　探讨单核细胞/淋巴细胞比值（MLR）、中性粒细胞百分比/白蛋白比值（NPAR）预测糖尿病性黄斑水肿（DME）的价值。
方法　选择 2018 年1月至 2023年2月新乡医学院第三附属医院收治的101例糖尿病视网膜病变患者为研究对象，根据眼底检查结果分为DME组（n=56）和非DME 组(n=45)。查阅患者病历，收集患者性别、年龄、糖尿病病程等一般资料和实验室指标。2组患者均于确诊后次日清晨采集空腹肘静脉血，采用全自动血常规分析仪检测单核细胞(MONO)计数、淋巴细胞(LYM)计数、白细胞(WBC)计数、中性粒细胞百分比(NEUT)、血浆白蛋白(ALB)及糖化血红蛋白（HbA1c）水平，计算MLR和NPAR。比较2组患者一般资料及实验室指标的差异，采用多因素 logistic 回归分析DME的危险因素，应用受试者操作特征(ROC)曲线评估MLR、NPAR对 DME 的预测价值。
结果　DME组患者的糖尿病病程、MONO计数、NEUT、MLR、NPAR、WBC计数、HbA1c水平高于非DME组 (P<0.05)；2组患者的性别、年龄、LYM计数、ALB水平比较差异无统计学意义(P>0.05)。多因素 logistic 回归分析显示，WBC、MLR、NPAR水平增高是DME发生的独立危险因素（P<0.05）。ROC曲线显示，MLR的最佳截断值为0.192，预测DME发生的曲线下面积（AUC）为 0.729（95%置信区间：0.631~0.826），灵敏度为 58.9%，特异度为 82.2%；NPAR的最佳截断值为14.040，预测DME发生的AUC为 0.884（95%置信区间：0.820~0.949），灵敏度为75.0%，特异度为91.1%；MLR、NPAR联合预测DME发生的曲线下面积为 0.906（95%置信区间：0.851~0.906），灵敏度为69.6%，特异度为93.3%。以MLR>0.192为阳性，NPAR>14.040为阳性，MLR、NPAR并联试验预测DME发生的灵敏度为87.5%，特异度为 71.1%，准确度为80.2%；MLR、NPAR串联试验预测DME发生的敏感度为46.4%，特异度为97.8%，准确度为69.3%。
结论　MLR、NPAR水平增高是DME发生的独立危险因素，对DME有一定的预测价值。 MLR、NPAR联合检测对DME的预测价值高于单独检测，且并联试验更有助于DME的早期预测。
Abstract:
Objective　To investigate the value of monocyte to lymphocyte ratio (MLR) and neutrophil percentage to albumin ratio (NPAR) in predicting diabetic macular edema (DME).
Methods　One hundred and one diabetic retinopathy patients admitted to the Third Affiliated Hospital of Xinxiang Medical University from January 2018 to February 2023 were selected as the research subjects,and they were divided into DME group (n=56) and non-DME group (n=45) based on fundus examination results.The general data such as gender,age,course of diabetes and laboratory indicators were collected by consulting medical records.Fasting elbow venous blood was collected early in the morning of the next day after the diagnosis of DME in both groups,the monocytes (MONO) count,lymphocyte (LYM) count,white blood cell (WBC) count,percentage of neutrophils (NEUT),plasma albumin (ALB),glycosylated haemoglobin (HbA1c) were measured by full automatic blood routine analyzer,and MLR,NPAR were calculated.General information and laboratory indexes of patients in the two groups were compared,and risk factors for DME were analyzed by multivariate logistic regression,and receiver operator characteristic (ROC) curve was applied to evaluate the predictive value of MLR and NPAR for DME.
Results　The course of diabetes,MONO count,NEUT,MLR,NPAR,WBC count,and HbA1c level of patients between the DME group were significantly higher than those in the non-DME group (P<0.05);there was no statistically significant difference in gender,age,LYM count,and ALB level of patients between the two groups (P>0.05).Multivariate logistic regression analysis showed that increased levels of WBC,MLR,and NPAR were independent risk factors for the occurrence of DME (P<0.05).The ROC curve showed that the best cut-off value of MLR was 0.192,and the area under the curve (AUC) for the prediction of DME was 0.729 (95% confidence interval:0.631-0.826),with a sensitivity of 58.9% and a specificity of 82.2%;while the best cut-off value of NPAR was 14.040,and the AUC for predicting DME occurrence was 0.884 (95% confidence interval:0.820-0.949),with a sensitivity of 75.0% and a specificity of 91.1%;the AUC of MLR and NPAP for predicting the occurrence of DME was 0.906 (95% confidence interval:0.851-0.906),with a sensitivity of 69.6% and a specificity of 93.3%.With MLR>0.192 as positive and NPAR>14.040 as positive,the parallel test of MLR and NPAR predicted the occurrence of DME with a sensitivity of 87.5%,a specificity of 71.1%,and an accuracy of 80.2%;while the tandem test of MLR and NPAR predicted the occurrence of DME with a sensitivity of 46.4%,a specificity of 97.8%,and an accuracy of 69.3%.
Conclusion　Increased levels of MLR and NPAR are independent risk factors for the occurrence of DME and have certain predictive value for DME.The predictive value of combined MLR and NPAR test for DME is higher than that of separate test,and parallel experiment is more helpful for the early prediction of DME.

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更新日期/Last Update: 2024-01-05