2型糖尿病足患者血小板相关参数特征及早期预测价值分析OA

Objective To investigate the clinical value of peripheral blood platelet-related parameters,lymphocyte count(LY),and hemoglobin(HB)in the occurrence and severity assessment of type 2 diabetic foot ulcer(DFU).Methods A total of 359 patients with type 2 diabetes mellitus admitted to Affiliated Hospital of Youjiang Medical University for Nationali-ties from January 2016 to May 2022 were retrospectively included.Among them,164 patients with simple diabetes mellitus were assigned to DM group,and 195 patients with DFU were assigned to DFU group.According to Wagner classification,the DFU group were further divided into mild group(Wagner grade 1-2,n=105)and severe group(Wagner grade 3-5,n=90).Clinical data and laboratory test indicators of all subjects were collected,including LY,HB,platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),and platelet-large cell ratio(P-LCR).Intergroup com-parisons and correlation analysis were performed.Multivariate logistic regression analysis was used to identify independent risk factors for DFU occurrence,and receiver operating characteristic(ROC)curves were constructed to evaluate the predic-tive efficacy of each indicator for severe DFU.Results Compared with the DM group,the DFU group had significantly higher PLT level and significantly lower levels of LY,HB,MPV,PDW,and P-LCR(all P＜0.001).The PLT level in the severe DFU group was significantly higher than that in the mild DFU group,while the levels of LY and HB were significantly lower(all P＜0.01).There were no statistically significant differences in MPV,PDW,and P-LCR between the two groups(all P＞0.05).Multivariate logistic regression analysis showed that increased age(OR=1.035,95％CI:1.011-1.059,P=0.004),elevated PLT(OR=1.009,95％CI:1.006-1.013,P＜0.001),decreased LY(OR=0.392,95％CI:0.259-0.596,P＜0.001),and decreased HB(OR=0.955,95％CI:0.941-0.970,P＜0.001)were independent risk factors for DFU occurrence.Spearman correlation analysis showed that PLT level was positively correlated with DFU severity(r=0.256,P＜0.001),while LY and HB levels were negatively correlated with DFU severity(r=-0.194,-0.312,all P＜0.01).ROC curve analysis showed that the area under the curve(AUC)of PLT for predicting severe DFU was 0.630(95％CI:0.559-0.717,P=0.001),with a optimal cut-off value of 292.5×109/L,a sensitivity of 33.7％,and a specificity of 66.3％.The AUCs of LY and HB alone for predicting severe DFU were 0.303 and 0.328,respectively,with low predictive value.Conclusion Elevated peripheral blood PLT,decreased LY and HB are closely related to the occurrence and severity of DFU in patients with type 2 diabetes mellitus.Among these,PLT has certain predictive value for severe DFU and can be used as a convenient indicator for early clinical screening of DFU.