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投稿时间：2022-02-06 网络发布日期：2022-07-20
投稿时间：2022-02-06 网络发布日期：2022-07-20
中文摘要: 目的 探讨血小板/淋巴细胞比值（PLR）、C-反应蛋白（CRP）与糖尿病足溃疡（DFU）严重程度的相关性，及二者对DFU预后的预测价值。
方法 回顾性纳入2016年10月至2020年12月河北省人民医院治疗的236例DFU患者的临床资料。依据患者6个月的预后，分为预后良好组160例（溃疡愈合），预后不良组76例（溃疡未愈合41例，截肢25例，死亡10例）。分析影响DFU患者预后的危险因素，评价PLR、CRP对 DFU患者预后的预测效能。
结果 随着下肢缺血与感染加重以及Wagner分级增加，PLR和CRP呈逐渐增高的趋势，差异有统计学意义（P＜0.05）。与预后良好组比较，预后不良组具有更长的糖尿病病程，更低的白蛋白水平，更高的血肌酐、CRP、PCT、PLR水平以及更高的重度下肢缺血、重度感染、Wagner 3～4级发生率（P＜0.01，P＜0.05）。多因素logistic回归分析结果显示，高水平CRP和PLR、重度感染、Wagner 3～4级（OR=1.443、1.761、1.665、1.893）是DFU患者预后不良的独立影响因素（P＜0.05，P＜0.01）。ROC曲线分析显示，PLR预测DFU患者预后不良的AUC ［0.883（95%CI:0.837～0.928）］高于CRP［0.766（95%CI:0.695～0.837），Z＝3.316，P＜0.01］。
结论 PLR、CRP水平随DFU患者病情严重度增加而升高，是DFU患者预后不良的独立影响因素，且以PLR的预测效能较高。
中文关键词: 糖尿病 糖尿病足溃疡 血小板/淋巴细胞比值 C-反应蛋白
Abstract:Objective To investigate the correlations of platelet-to-lymphoccyte ratio（PLR） and CRP with the severity of diabetic foot ulcer（DFU） and the prognosis of DFU. Methods A total of 236 DFU patients treated in Hebei General Hospital from October 2016 to December 2020 were retrospectively enrolled. According to 6-month prognosis, the patients were divided into good prognosis group（n=160, ulcer healing） and poor prognosis group（n=76, 41 cases of non-healing ulcer, 25 cases of amputation and 10 cases of death）. Multivariate logistic regression was used to analyze the risk factors for poor prognosis of DFU, and the predictive efficacy of PLR and CRP on the poor prognosis of DFU was evaluated. Results With the aggravation of lower limb ischemia and infection and the increase of Wagner grade, PLR and CRP increased gradually and statistically（P＜0.05）. Compared with good prognosis group, there were longer diabetes course, lower albumin level, higher serum creatinine, CRP, PCT and PLR levels and higher incidences of severe lower limb ischemia, severe infection and Wagner grade 3～4 in poor prognosis group（P＜0.01，P＜0.05）.Multivariate logistic regression analysis showed that high levels of CRP and PLR, severe infection and Wagner grade 3～4 DFU（OR=1.443,1.761,1.665,1.893） were the independent risk factors for poor prognosis in DFU patients(P＜0.05,P＜0.01). ROC curve analysis showed that in predicting poor prognosis of DFU patients，AUC of PLR ［0.883 (95%CI:0.837-0.928)］ was higher than that of CRP ［0.766 (95%CI:0.695-0.837),Z=3.316,P＜0.01］. Conclusion PLR and CRP levels increase with the severity of DFU patients, which are the independent influencing factors for poor prognosis of DFU, and PLR has a higher predictive efficacy.
文章编号： 中图分类号：R587.2 文献标志码：A
基金项目:河北省医学科学研究课题计划（20190002）
| Author Name | Affiliation |
| ZHENG Mei-jie*, LI Xian, GAO Zhe, YUAN Zheng, HU Jing, WEN Feng-hua, LYU Jian-na | *Department of Gastroenterology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China |
引用文本：
郑美洁,李贤,高哲,等.血小板/淋巴细胞比值和C-反应蛋白与糖尿病足溃疡严重程度及预后的关系[J].中国临床研究,2022,35(7):938-942,947.
郑美洁,李贤,高哲,等.血小板/淋巴细胞比值和C-反应蛋白与糖尿病足溃疡严重程度及预后的关系[J].中国临床研究,2022,35(7):938-942,947.