摘要
目的:探讨不同中医证型2型糖尿病患者中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血清胆红素(bilirubin,BIL)与踝肱指数(ankle brachial index,ABI)的关系,分析NLR与BIL对T2DM下肢动脉病变的诊断意义并为中医药防治下肢动脉病变提供客观依据。方法:纳入2型糖尿病住院患者159例,并根据中医四诊辨证分为阴虚热盛证、气阴两虚证、阴阳两虚证和血瘀脉络证,记录踝肱指数、血常规、生化全项,比较各中医证型组患者ABI、NLR、总胆红素(TBIL)、间接胆红素(IBIL)、直接胆红素(DBIL)水平的差异。结果:各中医证型组NLR、TBIL、IBIL、ABI水平组间比较差异有统计学意义(P﹤0.05)。经Sperman秩相关分析显示,2型糖尿病患者ABI与NLR呈显著负相关(rs=-0.706,P=0.001),与TBIL、IBIL呈显著正相关(rs=0.428,P=0.000;rs=0.380,P=0.001)。结论:糖尿病患者NLR的升高及TBIL、IBIL水平的降低与ABI的降低相关,高水平的NLR与低水平的TBIL、IBIL可能加重下肢动脉病变,加速糖尿病病程进展。血瘀脉络证型更易发生下肢动脉病变。
Objective:To approach the correlativity between neutrophil to lymphocyte ratio(NLR),serum bilirubin(BIL)and ankle-brachial index(ABI)of patients with type 2 diabetes mellitus(T2DM)with different TCM syndrome types,to analyze the diagnostic significance of NLR and BIL for T2DM caused lower extremity arterial disease,and to provide objective basis for TCM prevention and treatment of lower extremity arterial disease.Methods:159 cases of inpatients with type 2 diabetes mellitus were included,and divided into 4 TCM syndrome types by syndrome differentiation of TCM four diagnostic methods,i.e.syndrome of yin deficiency and excessive heat,deficiency of both qi and yin,deficiency of both yin and yang,and syndrome of blood-stasis obstructing collaterals.Ankle-brachial index,blood routine and biochemical whole items were recorded.The differences of levels of ABI,NLR,total bilirubin(TBIL),indirect bilirubin(IBIL)and direct bilirubin(DBIL)of patients were compared among groups of different TCM syndrome types.Results:Compared the levels of NLR,TBIL,IBIL and ABI among groups of different TCM syndrome types,the differences were statistically significant(P﹤0.05).Sperman rank correlation analysis showed that ABI of patients with type 2 diabetes mellitus was significantly negatively correlated to NLR(rs=-0.706,P=0.001),while significantly positively correlated to TBIL and IBIL(rs=0.428,P=0.000;rs=0.380,P=0.001).Conclusion:For diabetic patients,the increase of NLR and the decreases of TBIL and IBIL are correlated to the decrease of ABI.High level of NLR and low levels of TBIL and IBIL may aggravate the lower extremity arterial disease,and accelerate the progression of course of diabetes mellitus.Syndrome type of blood-stasis obstructing collaterals is more prone to lower extremity arterial disease.
作者
张思慧
郑曙琴
ZHANG Si-hui;ZHENG Shu-qin(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;不详)
出处
《山西中医》
2023年第7期57-60,共4页
Shanxi Journal of Traditional Chinese Medicine
关键词
2型糖尿病
中医证型
中性粒细胞与淋巴细胞比
踝肱指数
胆红素
相关性
type 2 diabetes mellitus
TCM syndrome types
neutrophil to lymphocyte ratio
anklebrachial index
bilirubin
correlativity
