血小板/淋巴细胞比值及中性粒细胞/淋巴细胞比值与糖尿病足感染患者骨髓炎及截肢的相关性研究

Relationship between platelet-lymphocyte ratio and neutrophil-lymphocyte ratio with osteomyelitis and amputation in patients with diabetic foot infection

目的探讨血小板/淋巴细胞比值(PLR)、中性粒细胞/淋巴细胞比值(NLR)、淋巴细胞/单核细胞比值(LMR)与糖尿病足感染(DFI)患者骨髓炎及截肢的相关性。方法选取2014年1月至2018年12月于我院就诊的T2DM合并DFI患者569例,分别分为骨髓炎组(OS,n=190)和非骨髓炎组(NOS,n=379)、截肢组(AM,n=82)和非截肢组(NAM,n=487),分析PLR、NLR、LMR与骨髓炎和截肢的相关性。结果OS组PLR高于NOS组[195.73(143.56,259.87)vs 167.68(110.66,239.22),P<0.01];AM组NLR、PLR高于NAM组[5.46(3.68,10.74)vs 4.16(2.80,6.75),213.07(158.97,303.54)vs 169.09(112.27,240.66),P<0.01],LMR低于NAM组[2.23(1.44,3.41)vs3.04(2.00,4.39),P<0.01]。Logistic回归分析结果显示,足溃疡病程、PLR是DFI患者骨髓炎发生的影响因素,C-RP、骨髓炎、NLR是DFI患者截肢的影响因素。受试者工作特征曲线分析表明,PLR预测DFI患者骨髓炎发生的最佳切点为141.57,敏感度和特异度分别为77.6%和42.2%;NLR预测DFI患者截肢的最佳切点为3.96,敏感度和特异度分别为73.2%和44.8%。结论PLR和NLR分别与DFI患者骨髓炎和截肢的发生相关。

Objective To evaluate the relationship between platelet to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR)and lymphocyte to monocyte ratio(LMR)with osteomyelitis and amputation in patients with diabetic foot infection(DFI).Methods A total of 569 patients with type 2 diabetes(T2DM)and DFI in our hospital were enrolled in this study from January 2014 to December 2018 and divided into four groups:osteomyelitis group(OS,n=190),non-osteomyelitis group(NOS,n=379),amputation group(AM,n=82),and non-amputation group(NAM,n=487).The relationships between PLR,NLR,LMR and osteomyelitis and amputation were analyzed.Results PLR was significantly higher in OS group than in NOS group[195.73(143.56,259.87)vs 167.68(110.66,239.22),P<0.05].NLR and PLR were significantly higher in AM group than in NAM group[5.46(3.68,10.74)vs 4.16(2.80,6.75),213.07(158.97,303.54)vs 169.09(112.27,240.66)].LMR were significantly lower in AM group than in NAM group[2.23(1.44,3.41)vs 3.04(2.00,4.39),P<0.05].Logistic regression analysis showed that duration of diabetic foot ulcers and PLR were risk factors for osteomyelitis in patients with DFI.NLR,C-reactive protein and osteomyelitis were risk factors for amputation in patients with DFI.The ROC curve analysis showed that the optimal cut-off point for PLR to predict the occurrence of osteomyelitis in DFI patients was 141.57 with 77.6%sensitivity and 42.2%specificity.The optimal cut-off point for NLR to predict the occurrence of amputation in DFI patients was 3.96 with 73.2%sensitivity and 44.8%specificity.Conclusion PLR and NLR were associated with osteomyelitis and amputation in patients with DFI,respectively.