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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (6): 602-605.doi: 10.3969/j.issn.1000-6621.2021.06.014

• 论著 • 上一篇    下一篇

中性粒细胞/淋巴细胞比值与2型糖尿病并发肺结核患者继发肺部感染相关性

谭守勇(), 袁园, 邝浩斌, 龚芳, 汪敏   

  1. 510095 广州市胸科医院结核内科 呼吸疾病国家重点实验室
  • 收稿日期:2021-01-14 出版日期:2021-06-10 发布日期:2021-06-02
  • 通信作者: 谭守勇 E-mail:tanshouyong@163.com
  • 基金资助:
    “十三五”国家科技重大专项(2018ZX10722301-001);广州市科技计划项目(155700012)

Correlation between neutrophil-to-lymphocyte ratio and the secondary pulmonary infection in type 2 diabetes mellitus complicated with pulmonary tuberculosis

TAN Shou-yong(), YUAN Yuan, KUANG Hao-bin, GONG Fang, WANG Min   

  1. State Key Laboratory of Respiratory Disease, Department of Tuberculosis in Guangzhou Chest Hospital, Guangzhou 510095, China
  • Received:2021-01-14 Online:2021-06-10 Published:2021-06-02
  • Contact: TAN Shou-yong E-mail:tanshouyong@163.com

摘要:

目的 探讨2型糖尿病(type 2 diabetes mellitus,T2DM)并发肺结核(pulmonary tuberculosis,PTB)患者继发肺部感染时外周血中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)变化情况。方法 采用回顾性研究方法,收集2013年1月至2018年1月首次在广州市胸科医院结核科住院治疗的951例T2DM并发初治菌阳PTB患者的临床资料,包括年龄、性别、临床症状、糖尿病史、糖化血红蛋白A1c(glycosylated hemoglobin A1c,HbA1c)、外周血白细胞(WBC)计数、中性粒细胞计数、淋巴细胞计数及抗感染治疗效果。研究对象根据入院治疗时是否继发肺部感染,分为感染组及非感染组;根据入院检查时,外周血淋巴细胞计数≥0.8×109/L与否,分为淋巴细胞计数正常组和低下组。分析NLR与研究对象继发肺部感染的相关性。结果 研究对象中继发肺部感染者有524例,占55.10%;感染组病灶范围以5~6个肺野为主(60.5%,317/524),明显高于非感染组(41.0%,175/427),差异有统计学意义(χ2=42.587,P=0.000)。感染组NLR水平[中位数(四分位数)]为6.79(5.10,9.70),明显高于非感染组[中位数(四分位数)为3.01(2.27,3.55)],差异有统计学意义(U=16 545.00,P=0.000)。感染组和非感染组外周血淋巴细胞计数低下者NLR水平[中位数(四分位数)分别为:12.09(8.67,16.05)和4.26(3.71,6.39)]均高于外周血淋巴细胞计数正常者[中位数(四分位数)分别为:5.90(4.71,7.55)和2.97(2.25,3.80)];外周血淋巴细胞计数低下者中性粒细胞计数[中位数(四分位数)分别为:6.42(5.01,9.07)×109/L 和3.13(1.88,3.51)×109/L]均低于外周血淋巴细胞计数正常者[中位数(四分位数)分别为:7.90(6.72,9.27)×109/L 和4.57(3.70,5.40)×109/L],差异均有统计学意义(U值分别为:5964.00、1695.50、18697.00、1257.00,P值均为0.000)。结论 T2DM并发PTB继发肺部感染患者NLR水平明显升高,且外周血淋巴细胞计数低下者容易继发肺部感染。

关键词: 结核,肺, 糖尿病,2型, 感染, 中性粒细胞/淋巴细胞比值

Abstract:

Objective To investigate the changes of neutrophil-to-lymphocyte ratio (NLR) in peripheral blood of secondary pulmonary infection patients with type 2 diabetes mellitus (T2DM) complicated with pulmonary tuberculosis (PTB). Methods A retrospective study was conducted in 951 T2DM patients complicated with PTB, who were hospitalized for the first time in the Tuberculosis Department of Guangzhou Chest Hospital from January 2013 to January 2018. They were newly treated and the TB detection is positive, the clinical data including age, gender, clinical symptoms, diabetes history, glycosylated hemoglobin A1c (HbA1c), peripheral blood white blood cell (WBC) count, neutrophil count, lymphocyte count and anti-infective treatment effect were analyzed. All the patients were divided into infection group and non-infection group according to whether they had secondary pulmonary infection when admission; according to whether the peripheral blood lymphocyte count was ≥0.8×109/L when admission, they were divided into normal group and low lymphocyte count group. The correlation between NLR and secondary lung infections in the study subjects was analyzed. Results Of the patients, 524 suffered secondary lung infection (55.10%); the lesion mainly involved 5-6 lung fields in the infected group (60.5%, 317/524), which was significantly higher than that in the non-infected group (41.0%, 175/427) (χ2=42.587, P=0.000). The NLR level of the infected group (M(Q1,Q3)) was 6.79 (5.10, 9.70), which was significantly higher than that of the non-infected group (3.01 (2.27, 3.55)) (U=16 545.00, P=0.000). The NLR levels (M(Q1,Q3)) of patients with low peripheral blood lymphocyte counts in the infected and non-infected groups were 12.09 (8.67, 16.05) and 4.26 (3.71, 6.39), respectively, both significantly higher than those of patients whose peripheral blood lymphocytes counts were normal (5.90 (4.71, 7.55), U=5964.00, P=0.000 and 2.97 (2.25, 3.80), U=1695.50, P=0.000, respectively). The neutrophil count (M(Q1,Q3)) of patients with low peripheral blood lymphocyte counts were 6.42 (5.01, 9.07)×109/L and 3.13 (1.88, 3.51)×109/L, in the two groups, which were significantly lower than those of patients with normal peripheral blood lymphocyte count (7.90 (6.72, 9.27)×109/L, U=18697.00, P=0.000 and 4.57 (3.70, 5.40)×109/L, U=1257.00, P=0.000, respectively). Conclusion The level of NLR in the secondary pulmonary infection in T2DM patients complicated with PTB was significantly increased, and patients with low peripheral blood lymphocyte counts were prone to secondary lung infection.

Key words: Tuberculosis,pulmonary, Diabetes Mellitus,Type 2, Infection, Neutrophil-to-lymphocyte ratio