背景:糖尿病足溃疡(DFU)是糖尿病最严重的晚期并发症之一。胫骨皮质横向运输(TTT)手术是解决DFU的主要方法。这种手术干预有望加快DFU伤口愈合并降低截肢率。炎症反应的缓解起着关键作用。在这项研究中,我们旨在探讨炎症与TTT手术之间的相关性,首要目标是促进临床实践中的快速预后评估。
目的:DFU的严重程度与临床检测结果之间的相关性仍然不明确。设计了一个临床预测模型来探索DFU严重程度与TTT手术疗效之间的联系。利用直接有效的临床指标。
方法:通过追踪广西医科大学第一附属医院接受TTT手术的DFU住院患者(南宁,中国)。通过逻辑回归和最小绝对收缩和选择操作员(LASSO)回归分析,确定了与DFU严重程度和手术后伤口愈合时间相关的指标。随后,建立了临床预测模型.最后,这两组指标的交叉显示了与伤口严重程度和术后愈合时间相关的因素.
结果:我们的研究包括202例患者,根据Wagner的分级分类分为2组。利用学生的t检验,LASSO回归和逻辑回归分析,我们确定了3个指示DFU严重程度的因素:血小板与淋巴细胞比率(PLR),混合淋巴细胞反应(MLR)和血红蛋白(HGB)。单因素COX回归分析显示:白细胞(WBC),中性粒细胞(NEUT),单核细胞(MO),PLR,MLR,中性粒细胞与淋巴细胞比率(NLR),红细胞沉降率(ESR),年龄,淋巴细胞(LY),单核细胞与中性粒细胞比率(MNR),尿酸(UA),和白蛋白(ALB)与术后愈合时间相关。最终,我们确定了两个因素,PLR和MNR,在这两个数据集的交叉点。
结论:血小板与淋巴细胞比率和MNR被确定为与DFU严重程度和TTT手术后预后相关的因素。
BACKGROUND: Diabetic foot ulcers (DFUs) represent one of the most severe late-stage complications of diabetes. Tibial cortex transverse transport (TTT) surgery stands as the prevailing method for addressing DFUs. This surgical intervention holds the promise of expediting DFU wound healing and diminishing the rate of amputations, with the mitigation of inflammatory responses playing a pivotal role. In this study, we aim to explore the correlation between inflammation and TTT surgery, with the overarching goal of facilitating swift prognostic assessments in clinical practice.
OBJECTIVE: The correlation between the severity of DFUs and clinical test results remains ambiguous. A clinical prediction model was devised to explore the connection between DFU severity and the efficacy of TTT surgery, utilizing straightforward and efficient clinical indicators.
METHODS: Clinical data and examination results were gathered by tracking hospitalized DFU patients who underwent TTT surgery at the First Affiliated Hospital of Guangxi Medical University (Nanning, China). Indicators associated with DFU severity and wound healing time post-surgery were identified through logistic regression and least absolute shrinkage and selection operator (LASSO) regression analyses. Subsequently, a clinical prediction model was constructed. Finally, the intersection of these 2 sets of indicators revealed factors correlated with wound severity and post-operative healing duration.
RESULTS: Our study was comprised of 202 patients who were categorized into 2 groups based on Wagner\'s grading classifications. Utilizing Student\'s t-tests, LASSO regression and logistic regression analyses, we identified 3 factors indicative of DFU severity: platelet-to-lymphocyte ratio (PLR), mixed lymphocyte reaction (MLR) and hemoglobin (HGB). Univariate COX regression analysis revealed 12 factors such as: white blood cells (WBC), neutrophils (NEUT), monocytes (MO), PLR, MLR, neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR), age, lymphocytes (LY), monocyte-to-neutrophil ratio (MNR), uric acid (UA), and albumin (ALB) associated with the postoperative healing duration. Ultimately, we identified 2 factors, PLR and MNR, at the intersection of these 2 datasets.
CONCLUSIONS: Platelet-to-lymphocyte ratio and MNR were identified as factors associated with both the severity of DFUs and the prognosis following TTT surgery.