中性粒细胞淋巴细胞比值与糖尿病足溃疡病情严重程度的关系及对预后的预测价值

目的探讨糖尿病足溃疡(DFU)患者中性粒细胞淋巴细胞比值(NLR)与其病变严重程度的相关性及对预后的预测价值。方法回顾性分析2016年6月—2020年6月收治的DFU 176例的临床资料。收集入院时NLR、C反应蛋白(CRP)等指标,分析不同DFU病情、下肢缺血及感染程度NLR水平。根据随访6个月时转归分为预后良好组和预后不良组,应用多因素Logistic回归分析DFU患者预后不良的危险因素,并采用受试者工作特征(ROC)曲线评估NLR对DFU患者预后不良的预测价值。结果随病情严重程度、下肢缺血程度、感染程度加重NLR水平逐渐升高(P<0.01)。176例随访6个月后溃疡预后不良60例(34.09%)。NLR>6.58、CRP>58.35 mg/L是DFU患者预后不良的危险因素。NLR以7.17为临界值预测DFU患者预后不良的曲线下面积高于CRP(P<0.01)。结论DFU患者短期预后不良风险高,NLR能反映其病变程度,且早期预测预后不良的价值高于CRP。

Correlation between Neutrophil-to-Lymphocyte Ratio with the Severity of Diabetic Foot Ulcer and Its Value in Pre-diction of Prognosis

Objective To investigate the correlation between neutrophil-to-lymphocyte ratio(NLR)with the severity of diabetic foot ulcer(DFU)and its value in prediction of patients'prognoses.Methods Clinical data of 176 patients with DFU admitted between June 2016 and June 2020 was retrospectively analyzed.Indicators including NLR and C-reactive protein(CRP)at admission were collected,and NLR levels in patients with different DFU conditions,lower limb ischemia and infection degree were analyzed.According to outcomes at the 6^th months of follow-up,the patients were divided into good prognosis group and poor prognosis group.Multivariate Logistic regression was used to analyze risk factors for poor prognoses of DFU patients,and receiver operating characteristic(ROC)curve was used to evaluate the value of NLR in prediction of poor prognosis of DFU patients.Results NLR level was increased gradually with aggravated severity of the disease,degree of lower limb ischemia and degree of infection(P<0.01).All the 176 patients were followed up for 6 months,and the prognosis of ulcer was poor in 60 patients(34.09%).NLR more than 6.58 and CRP more than 58.35 mg/L were risk factors for poor prognoses in patients with DFU.The area under ROC(AUC)of NLR with 7.17 as the critical value to predict poor prognoses in patients with DFU was significantly larger than that by CRP(P<0.01).Conclusion DFU patients have high risk for short-term poor prognoses.NLR may reflect the severity of disease and its value in early predicting poor prognoses is better than that by CRP.