Tardáguila-García Aroa, García Álvarez Yolanda, García-Morales Esther, Álvaro-Afonso Francisco Javier, Sanz-Corbalán Irene, Lázaro-Martínez José Luis
Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
J Clin Med. 2020 Nov 22;9(11):3768. doi: 10.3390/jcm9113768.
The evidence is still unclear regarding the role of blood parameters in detecting complications in patients who suffer from diabetic foot osteomyelitis (DFO). In this study, the aim was to identify the capacity of different blood parameters in the diagnosis and prediction of the onset of complications. A cross-sectional prospective study was carried out with 116 DFO patients. The following blood parameters were evaluated during 1 year of follow-up: leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, erythrocyte sedimentation rate (ESR), glycemia, glycosylated hemoglobin, C-reactive protein (CRP), alkaline phosphatase, albumin, and creatinine. Complication events were assessed for each participant during the study period. We investigated the association between blood parameter values and the onset of complication events by conducting a receiver operating characteristic curve analysis. Eighty-five (73.3%) patients developed complications. Regarding blood parameters, higher values of lymphocytes and albumin were predictive factors at the 12-month follow-up once the ulcer had healed. Higher values of ESR had predictive and diagnostic value for the onset of complication events, and higher values of CRP and hyperglycemia were diagnostic factors since they were elevated during the occurrence of an event. In conclusion, after suffering from DFO, the elevation of lymphocytes, ESR, CRP, albumin, and glycemia could be useful in detecting and diagnosing patients who are likely to develop a complication. Serial blood tests are a useful tool for early detection by healthcare professionals to prevent complications.
关于血液参数在糖尿病足骨髓炎（DFO）患者并发症检测中的作用，证据仍不明确。在本研究中，目的是确定不同血液参数在诊断和预测并发症发生方面的能力。对116例DFO患者进行了一项横断面前瞻性研究。在1年的随访期间评估了以下血液参数：白细胞、中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞、嗜碱性粒细胞、红细胞沉降率（ESR）、血糖、糖化血红蛋白、C反应蛋白（CRP）、碱性磷酸酶、白蛋白和肌酐。在研究期间对每位参与者的并发症事件进行了评估。我们通过进行受试者工作特征曲线分析，研究了血液参数值与并发症事件发生之间的关联。八十五名（73.3%）患者出现了并发症。关于血液参数，一旦溃疡愈合，在12个月的随访中，淋巴细胞和白蛋白的较高值是预测因素。ESR的较高值对并发症事件的发生具有预测和诊断价值，CRP和高血糖的较高值是诊断因素，因为它们在事件发生期间升高。总之，患有DFO后，淋巴细胞、ESR、CRP、白蛋白和血糖的升高可能有助于检测和诊断可能发生并发症的患者。系列血液检查是医疗保健专业人员进行早期检测以预防并发症的有用工具。
