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中性粒细胞-淋巴细胞比值在糖尿病视网膜病变诊断中的意义: Meta分析

冀帅飞  宁小娜  张婕   

  1. 710038 空军军医大学唐都医院眼科
  • 收稿日期:2018-03-27 出版日期:2018-11-25 发布日期:2018-12-11
  • 通讯作者: 张婕,Email:jessicazhangjie@hotmail.com E-mail:jessicazhangjie@hotmail.com

Neutrophil to lymphocyte ratio for diagnosis of diabetic retinopathy: a Meta-analysis

JI Shuai-fei, NING Xiao-na, ZHANG Jie   

  1. Department of Ophthalmology, TangDu Hospital, Air Force Military Medical University, Xi’an, Shannxi, 710038, China
  • Received:2018-03-27 Online:2018-11-25 Published:2018-12-11
  • Contact: ZHANG Jie, Email: jessicazhangjie@hotmail.com E-mail:jessicazhangjie@hotmail.com

摘要:

目的 分析中性粒细胞-淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)在糖尿病视网膜病变(diabetic retinopathy,DR)诊断中的临床意义。设计Meta分析。研究对象 单纯Ⅱ型糖尿病和Ⅱ型糖尿病发生视网膜病变患者中性粒细胞-淋巴细胞比值相关的中英文文献。 方法 计算机检索PubMed、Embase、Cochrane、中国知网和万方数据库,并阅读参考文献以期纳入充足研究。采用Review manager 5.3和Stata 14.0软件进行数据分析。改变效应模型进行敏感性分析,漏斗图和Egger’s 检验发表偏倚。主要指标 中性粒细胞-淋巴细胞比值。 结果 纳入11项研究,包括982例DR 患者、1224例单纯Ⅱ型糖尿病患者和683例健康对照人群。Meta分析结果表明,DR患者的NLR水平显著高于健康人群[SMD (95% CI)=0.90(0.36, 1.44), P<0.001]和单纯Ⅱ型糖尿病患者[SMD(95% CI)=0.69(0.41, 0.97), P<0.001]。亚组分析结果表明NLR水平在非增生性和增生性糖尿病视网膜病变之间的差异无统计学意义。 结论 Meta分析结果表明,DR患者的NLR水平明显升高是糖尿病患者发生视网膜病变风险的预测因子,可能为DR的临床诊断和管理提供依据。

关键词: 中性粒细胞-淋巴细胞比值, 糖尿病视网膜病变, Meta分析

Abstract:

Objective To explore the clinical significance of neutrophil to lymphocyte ratio (NLR) in diagnosis and monitoring of diabetic retinopathy (DR). Design Meta-analysis. Participants Published clinical studies reporting both NLR and DR. Methods Literatures were retrieved by formal searching of PubMed, Embase, Cochrane, CNKI and WanFang, and by hand searching of reference lists of related articles. Review manager 5.3 and Stata 14.0 statistical softwares were utilized for processing, and effect model was changed to perform sensitivity analysis, and publication bias was conducted by Egger’s test. Main Outcome Measures NLR level. Results  Eleven eligible studies involving 982 DR patients, 1224 type Ⅱdiabetes mellitus (T2DM) without DR patients and 683 healthy subjects were included. Meta-analysis showed that NLR level in DR was significantly higher than healthy controls [SMD (95% CI) =0.90 (0.36, 1.44), P<0.001] and T2DM without DR [SMD (95% CI) =0.69 (0.41, 0.97), P<0.001], respectively. Subgroups suggested that there was no statistical significance of NLR between nonproliferative diabetic retinopathy and proliferative diabetic retinopathy. Conclusion The higher level NLR appeares in DR compared to control and T2DM without DR, which suggests the risk of retinopathy in T2DM and might provides an evidence to monitor the development of DR clinically.

Key words: neutrophil to lymphocyte ratio, diabetic retinopathy, Meta-analysis