平均血小板体积与血小板比值与2型糖尿病颈动脉硬化相关性研究

Correlation between Mean Platelet Volume and Platelet Ratio and Carotid Arteriosclerosis in Type 2 Diabetes Mellitus

摘要: 目的：探讨平均血小板体积/血小板比值(MPR)与2型糖尿病颈动脉粥样硬化的相关性。方法：回顾性分析2021年8月至2021年12月于青岛大学附属医院内分泌科住院的210例2型糖尿病患者，将74例单纯糖尿病患者作为对照组，136例合并颈动脉硬化的患者作为观察组，并按颈部超声结果按斑块数量分组，收集患者临床基线资料，血常规、血脂、空腹血糖、糖化血红蛋白等结果，计算MPR比值，比较2型糖尿病颈动脉硬化与MPR的相关性。再将观察组按年龄分为3组，分别为<45岁组、45~55岁组、>55岁组，比较MPR水平，分析其在2型糖尿病合并颈动脉硬化中的临床价值。结果：观察组的病程、年龄、MPR显著高于对照组，观察组的血小板计数显著低于对照组(P < 0.05)，差异具有统计学意义。两组在性别、吸烟、饮酒、收缩压、舒张压、空腹血糖、糖化血红蛋白、平均血小板体积等指标无统计学意义(P > 0.05)。<45岁组与其余2组比较，MPR差异具有统计学意义。多因素Logistic回归分析提示，在校正部分危险因素如年龄、病程后，MPR仍然是2型糖尿病患者合并颈动脉硬化的危险因素。绘制受试者曲线(ROC)，当MPR切点(cut-off)为0.043时，敏感性和特异性为58.8%、62.2%，AUC为64.5 (95% CI: 0.566~0.723, P = 0.001)。结论：2型糖尿病患者外周血MPR水平升高与颈动脉粥样硬化具有相关性，可作为反映2型糖尿病患者颈动脉粥样硬化的辅助指标。

Abstract: Objective: To explore the correlation between mean platelet volume/platelet ratio (MPR) and ca-rotid atherosclerosis in type 2 diabetes mellitus. Methods: A total of 210 patients with type 2 dia-betes mellitus who were hospitalized in the Department of Endocrinology of the Affiliated Hospital of Qingdao University from August 2021 to December 2021 were retrospectively analyzed. 74 pa-tients with simple diabetes mellitus were selected as the control group, and 136 patients with ca-rotid atherosclerosis were selected as the observation group. Clinical baseline data, blood routine and blood lipids, fasting blood glucose, and glycosylated hemoglobin were collected, MPR ratio was calculated, and the correlation was compared. The observation group was then divided into three groups according to age: <45 years old group, 45~55 years old group, and >55 years old group. The MPR level was compared, to analyze its clinical value in type 2 diabetes mellitus complicated with carotid atherosclerosis. Results: The course of disease, age and MPR in observation group were sig-nificantly higher than those in control group, the platelet count in the observation group was signif-icantly lower than that in the control group (P < 0.05), and the difference was statistically significant. There were no significant differences in gender, smoking, drinking, systolic blood pressure, diastolic blood pressure, fasting blood glucose, glycosylated hemoglobin and mean platelet volume between the two groups (P > 0.05). The MPR difference between the <45 year old group and the other two groups has statistical significance. Multivariate logistic regression analysis indicated that MPR was still a risk factor for carotid arteriosclerosis in type 2 diabetes patients after adjusting for some risk factors such as age and course of disease. The receiver’s curve (ROC) was plotted. When the MPR cut-off point (cut-off) was 0.043, the sensitivity and specificity were 58.8% and 62.2%, and the AUC was 64.5 (95% CI: 0.566~0.723, P = 0.001). Conclusion: The increase in MPR level is correlated with carotid atherosclerosis in patients with type 2 diabetes mellitus, which can be used as an auxiliary index to reflect carotid atherosclerosis in patients with type 2 diabetes mellitus.