[1]杨文静,刘 宾,崔 鑫,等.中性粒细胞与淋巴细胞比值和血小板计数对慢性难愈性创面术后感染的预测价值[J].陕西医学杂志,2021,50(5):546-549.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.008]
　YANG Wenjing,LIU Bin,CUI Xin,et al.Predictive value of NLR and PLT for postoperative infection of chronic refractory wounds[J].,2021,50(5):546-549.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.008]
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中性粒细胞与淋巴细胞比值和血小板计数对慢性难愈性创面术后感染的预测价值
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年5期
页码:
546-549
栏目:
临床研究
出版日期:
2021-05-05

文章信息/Info

Title:
Predictive value of NLR and PLT for postoperative infection of chronic refractory wounds
作者:
杨文静1; 刘 宾2; 崔 鑫2; 马戈甲2; 韩 悦2; 任 杰2
(1.延安大学医学院,陕西 延安 716000; 2.西安市中心医院烧伤整形美容外科,陕西 西安 710003)
Author(s):
YANG Wenjing; LIU Bin; CUI Xin; MA Gejia; HAN Yue; REN Jie
(Medical School of Yan'an University,Yan'an 716000,China)
关键词:
慢性难愈性创面;  术后感染;  血小板计数;  中性粒细胞与淋巴细胞比值;  ROC曲线;  预测价值
Keywords:
Chronic refractory wounds;  Postoperative infection;  Platelet count;  Neutrophil-to-lymphocyte ratio;  ROC curve;  Predictive value
分类号:
R 632
DOI:
DOI:10.3969/j.issn.1000-7377.2021.05.008
文献标志码:
A
摘要:
目的:探讨中性粒细胞与淋巴细胞比值(NLR)和血小板计数(PLT)预测慢性难愈性创面术后感染的价值。方法:回顾性分析经过手术治疗的慢性难愈性创面患者120例,根据国际伤口感染研究所(IWII)提出的局部伤口感染临床表现分为未感染组(65例)和感染组(55例)。比较两组一般资料和血液参数。慢性创面术后感染的危险因素采用Logistic回归分析。利用受试者工作特征(ROC)曲线评估NLR和PLT对慢性创面术后感染的预测价值。结果:感染组白细胞计数、PLT、中性粒细胞计数、NLR、PLR和糖尿病患者占比高于未感染组(均P<0.05)。以慢性创面术后发生感染为因变量,以糖尿病(无=0,有=1)、白细胞计数、中性粒细胞计数、淋巴细胞计数、平均血小板体积,NLR、PLT、PLR为自变量,进行Logistic回归分析,显示PLT和NLR是慢性创面术后感染的独立危险因素(均P<0.05)。ROC曲线分析显示,NLR、PLT预测患者慢性创面术后感染的曲线下面积分别为0.818、0.802,最佳诊断截点分别为2.34、248.5×109/L,敏感性分别为80.0%、74.5%,特异性分别为75.4%、81.5%。结论:NLR和PLT对慢性难愈性创面术后感染具有一定预测价值。
Abstract:
Objective:To explore the value of neutrophil to lymphocyte ratio(NLR)and platelet count(PLT)in predicting postoperative infection of chronic refractory wounds.Methods:A retrospective analysis of 120 patients with chronic refractory wounds who underwent surgical treatment was divided into non-infected group(65 cases)and infected group(55 cases).The general data and blood indicators of the two groups were compared.Logistic regression was used to analyze the risk factors of postoperative infection in chronic wounds.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of NLR and PLT for postoperative infection of chronic wounds.Results:The white blood cell count,PLT,neutrophil count,lymphocyte count,mean platelet volume,NLR,PLR and the proportion of diabetes in the non-infected group were higher than those in the infected group(all P<0.05).Taking postoperative infection after chronic wounds as the dependent variable,diabetes,white blood cell count,neutrophil count,lymphocyte count,average platelet volume,NLR,PLT as independent variables,and Logistic regression analysis showed that PLT and NLR were independent risk factors for postoperative infection of chronic wounds(all P<0.05).ROC curve analysis showed that the area under the curve for NLR and PLT to predict postoperative infection of patients with chronic wounds were 0.818 and 0.802,respectively.The best diagnostic cut-off values were 2.34 and 248.5×109/L,and the sensitivities were 80.0% and 74.5%,and the specificities were 75.4% and 81.5%,respectively.Conclusion:NLR and PLT have certain predictive value for postoperative infection of chronic refractory wounds.

参考文献/References:

[1] Jarbrink K,Ni G,Sonnergren H,et al.The humanistic and economic burden of chronic wounds:A protocol for a systematic review[J].Syst Rev,2017,6(1):15.
[2] Suthar M,Gupta S,Bukhari S,et al.Treatment of chronic non-healing ulcers using autologous platelet rich plasma:A case series[J].J Biomed Sci,2017,24(1):16.
[3] Powers JG,Higham C,Broussard K,et al.Wound healing and treating wounds:Chronic wound care and management[J].J Am Acad Dermatol,2016,74(4):607-625.
[4] 肖厚安,王 梅,周小茜,等.自体微粒皮移植治疗慢性难愈性创面98例[J].陕西医学杂志,2015,44(10):1323,1350.
[5] Tang L,Li X,Wang B,et al.Prognostic value of neutrophil-to-lymphocyte ratio in localized and advanced prostate cancer:A systematic review and meta-analysis[J].PLoS One,2016,11(4):e0153981.
[6] Wu Y,Chen Y,Yang X,et al.Neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)were associated with disease activity in patients with systemic lupus erythematosus[J].Int Immunopharmacol,2016,36:94-99.
[7] 李建伟,张 婕,王 曼,等.高血压前期人群血压昼夜节律与中性粒细胞淋巴细胞比值的关系研究[J].陕西医学杂志,2020,49(10):1283-1287.
[8] 张培杰,许 铁.中性粒细胞/淋巴细胞比值对脓毒症患者病情严重程度及预后的评估和预测价值[J].中国急救复苏与灾害医学杂志,2018,13(7):642-647.
[9] Haesler E,Swanson T,Ousey K,et al.Clinical indicators of wound infection and biofilm:Reaching international consensus[J].Journal of Wound Care,2019,28:4-12.
[10] Harries RL,Bosanquet DC,Harding KG.Wound bed preparation:Time for an update[J].International Wound J,2016,13(3):8-14.
[11] Guo S,Dipietro LA.Factors affecting wound healing[J].J Dent Res,2010,89(3):219-229.
[12] Robson MC,Barbul A.Guidelines for the best care of chronic wounds[J].Wound Repair Regen,2006,14(6):647-710.
[13] Li Y,Zhao Y,Feng L,et al.Comparison of the prognostic values of inflammation markers in patients with acute pancreatitis:A retrospective cohort study[J].BMJ Open,2017,7:13206.
[14] Hofer HP,Egger G,Kukovetz EM,et al.The influence of trauma on changes in neutrophil granulocyte function assessed by an analysis of granulocyte migration[J].Langenbecks Arch Chir,1996,381(3):148-154.
[15] Zhang S,Diao J,Qi C,et al.Predictive value of neutrophil to lymphocyte ratio in patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention:A meta-analysis[J].BMC Cardiovasc Disord,2018,18(1):75-83.
[16] Imtiaz F,Shafique K,Mirza SS,et al.Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population[J].Int Arch Med,2012,5(1):2-7.
[17] Ong E,Farran S,Salloum M,et al.Does everything that's counted count?Value of inflammatory markers for following therapy and predicting outcome in diabetic foot infection[J].Int J Low Extrem Wounds,2017,16(2):104-107.
[18] Altay FA,Kuzi S,Altay M,et al.Predicting diabetic foot ulcer infection using the neutrophil-to-lymphocyte ratio:A prospective study[J].Journal of Wound Care,2019,28(9):601-607.
[19] Liu WY,Lin SG,Wang LR,et al.Platelet-to-lymphocyte ratio:A novel prognostic factor for prediction of 90-day outcomes in critically ill patients with diabetic ketoacidosis[J].Medicine,2016,95(4):2596.
[20] Mancuso ME,Santagostino E.Platelets:Much more than bricks in a breached wall[J].Br J Haematol,2017,178(2):209-219.
[21] Iannacone M.Platelet-mediated modulation of adaptive immunity[J].Semin Immunol,2016,28(6):555-560.
[22] Demetriou M,Papanas N,Panopoulou M,et al.Determinants of microbial load in infected diabetic foot ulcers:A pilot study[J].Int J Endocrinol,2013,2013:858206.

备注/Memo

备注/Memo:
基金项目:陕西省科技厅社会发展攻关项目(2020SF-184)
更新日期/Last Update: 2021-05-06