[1]胡天喜a,闫　彬a,陶林静a,等.糖尿病并发新型冠状病毒肺炎患者临床实验室常规检测指标变化及应用价值研究[J].现代检验医学杂志,2022,37(03):132-137.[doi:10.3969/j.issn.1671-7414.2022.03.028]
　HU Tian-xia,YAN Bina,TAO Lin-jinga,et al.Changes and Application Value of Clinical Laboratory Routine Testing Indicators in Patients with Diabetes Mellitus Complicated with Corona Virus Disease 2019[J].Journal of Modern Laboratory Medicine,2022,37(03):132-137.[doi:10.3969/j.issn.1671-7414.2022.03.028]
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糖尿病并发新型冠状病毒肺炎患者临床实验室常规检测指标变化及应用价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年03期
页码:
132-137
栏目:
新型冠状病毒肺炎检验专题
出版日期:
2022-05-15

文章信息/Info

Title:
Changes and Application Value of Clinical Laboratory Routine Testing Indicators in Patients with Diabetes Mellitus Complicated with Corona Virus Disease 2019
文章编号:
1671-7414（2022）03-132-07
作者:
胡天喜a; 闫　彬a; 陶林静a; 叶亚平a; 夏盼盼b
（南阳市中心医院a. 医学检验科；b. 感染性疾病科，河南南阳 473000）
Author(s):
HU Tian-xia;  YAN Bina;  TAO Lin-jinga;  YE Ya-pinga;  XIA Pan-panb
(a.Department of Laboratory Medicine；b.Department of Infectious Diseases, Nanyang Central Hospital, Henan Nanyang 473000, China)
关键词:
新型冠状病毒肺炎; 糖尿病; 实验室检测
分类号:
R587.2；R373.19；R446.11
DOI:
10.3969/j.issn.1671-7414.2022.03.028
文献标志码:
A
摘要:
目的　探讨糖尿病并发新型冠状病毒肺炎（ corona virus disease 2019，COVID 19）患者的临床常规实验室指标变化及其临床意义。方法　收集 2020年 1月 21日～ 3月 2日在河南省南阳市中心医院感染性疾病科就诊的 COVID 19患者，分为糖尿病（diabetes mellitus，DM）组和非糖尿病（non-diabetes mellitus，NDM）组，采用 Mann-Whitney U检验和 Kruskal-Wallis H检验比较组间常规检测指标的差异，并用 Logistic回归对重症患者进行危险因素分析。结果　①共有 NDM组 36例，DM组 17例，DM组的年龄显著高于 NDM组（59.12±10.92 岁 vs 45.03±16.73岁），差异具有统计学意义（ t=3.31，P=0.001）；②与 NDM组相比， DM组的中性粒细胞计数 [（5.85±3.29 ）×109/L]，纤维蛋白原浓度（4.71±1.37 g/L），D-二聚体 [0.63（0.22，2.81) mg/L ] ,C反应蛋白 [18.30（12.81，54.10）mg/L]和白细胞介素 -4（2.55± 0.49pg/ml）水平显著高于 NDM组 [（3.41±1.93）×109/L，3.54±0.82 g/L，0.22(0.16，0.39) mg/L，8.05(1.59，16.45）mg/L，（2.01±0.63pg/ml）]，差异均有统计学意义（ t=2.45～ 3.40，均 P ＜ 0.05），而淋巴细胞计数显著低于 NDM组 [（0.83±0.45）×109/L vs（1.32±0.50）×109/L]，差异有统计学意义（ t=-3.42，P=0.001）；③随着血糖水平的升高， COVID-19患者的淋巴细胞计数逐渐降低 [（1.50±0.41）×109/L，（1.19±0.55 ）×109/L，（0.78±0.33）×109/L]，差异有统计学意义（ F=13.93，P=0.001），而纤维蛋白原浓度（ 3.24±0.54 g/L，3.90±0.98 g/L，4.63±1.53 g/L）、 D-二聚体 [0.16（0.12，0.42）mg/L， 0.27（0.16， 0.44）mg/L，0.63（0.22，2.81）mg/L ]和 C反应蛋白 [5.10（1.58， 10.84）mg/L，9.40（2.80，28.40）mg/L，27.93（12.81，64.39）mg/L]水平逐渐升高，差异有统计学意义（ F=9.30～ 13.32，均 P＜ 0.05）；④ DM组患重症（包括重型和危重型） COVID-19的比例显著高于 NDM组（58.80% vs 16.67%），差异有统计学意义（ χ2=0.43，P=0.002），且住院时间显著长于 NDM患者（15.18±5.43天 vs 10.39±5.82天），差异有统计学意义（ t=2.87，P=0.004）。调整性别和年龄后发现，淋巴细胞计数（风险比 [HR]=0.023，P=0.011）、糖尿病（ HR=5.33， P=0.026）是 COVID-19患者罹患重症的独立危险因素。结论　糖尿病并发 COVID-19患者处于高凝状态，炎症反应更显著，糖尿病是 COVID-19患者罹患重症的独立危险因素。
Abstract:
Objective　To explore the clinical routine laboratory changes and their clinical significance in patients with diabetes mellitus complicated with corona virus disease 2019 (COVID-19). Methods　The test data of COVID-19 patients were collected from January 21st to March 2nd, 2020 in the Department of Infectious Diseases, Nanyang Central Hospital of Henan Province. The patients were divided into a Diabetes Mellitus (DM) group and a non-Diabetes Mellitus (NDM) group. Mann-Whitney U test and Kruskal-Wallis H test were used to compare the differences between the two groups, and Logistic regression analysis was used to analyze the risk factors of severe patients. Results　① There were 36 cases in the non-DM group and 17 cases in the DM group. The age of the DM group was significantly higher than that of the non-DM group (59.12±10.92 years vs 45.03±16.73 years), the difference was statistically significant (t=3.31, P=0.001). ② The neutrophil count[（5.85±3.29）×109/L], FIB （4.71± 1.37 g/L）, D-dimer [0.63（0.22，2.81) mg/L], C-reactive protein [18.30（12.81，54.10）mg/L] and interleukin-4 levels（ 2.55±0.49 pg/ml）of the DM group were significantly higher than those in the non-DM group[（3.41±1.93）×109/L，3.54±0.82 g/L， 0.22(0.16，0.39) mg/L，8.05(1.59，16.45）mg/L，2.01±0.63pg/ml]，the differences were statistically significant （t=2.45 ~ 3.40， all P ＜ 0.05）, while the lymphocyte count was significantly lower than those of the non-DM group[（0.83±0.45）×109/L vs （1.32±0.50）×109/L]，the difference was statistically significant（t=-3.42，P=0.001）. ③ With the increase of blood glucose levels, the lymphocyte count [（1.50±0.41）×109/L,（1.19±0.55）×109/L,（0.78±0.33）×109/L] of COVID-19 patients gradually decreased, while FIB （3.24±0.54 g/L，3.90±0.98 g/L，4.63±1.53 g/L）, D-dimer [0.16（0.12，0.42） mg/L，0.27（0.16，0.44）mg/L，0.63（0.22，2.81）mg/L] and C-reactive protein [5.10（1.58，10.84）mg/L，9.40（2.80， 28.40）mg/L，27.93（12.81，64.39）mg/L] levels gradually increased ，the differences were statistically significant（F=9.30 ~ 13.93，respectively，all P ＜ 0.05）. ④ The proportion of severe COVID-19(58.80% vs 16.67%) and hospital stay（15.18±5.43 day vs 10.39±5.82 day）in the DM group were significantly higher than that of the non-DM group, the differences were statistically significant（χ2=0.43, P=0.002；t=2.87, P=0.004）. After adjusting for gender and age, lymphocyte count (hazard ratio [HR]=0.023, P=0.011) and diabetes (HR=5.33, P=0.026) were independent risk factors for severe COVID-19 patients. Conclusion　COVID-19 patients with diabetes were in a hypercoagulable state, and the inflammatory response was more pronounced. Individualized hypoglycemic therapy should be implemented for them.

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备注/Memo

备注/Memo:
基金项目：河南省重点研发与推广专项科技攻关项目（212102310805）；南阳市重点研发与推广专项科技攻关项目（KJGG093）。
作者简介：胡天喜（1977-），男，本科，主管技师，研究方向：血液学、流行病学，E-mail:hutianxi1977@163.com。
通讯作者：闫彬，男，硕士，主管技师，研究方向：血栓与止血，E-mail: sudayanbin@163.com。
更新日期/Last Update: 1900-01-01