[1]赵荣亚 王鹏华 张靖航 孙幸幸 侯小丽.血清降钙素原对糖尿病足感染患者 截趾风险的预测价值[J].国际内分泌代谢杂志,2015,(06):370-373.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.06.003]
　Zhao Rongya,Wang Penghua,Zhang Jinghang,et al.Predictive value of serum procalcitonin in amputation risk of patients with diabetic foot infection[J].International Journal of Endocrinology and Metabolism,2015,(06):370-373.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.06.003]
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血清降钙素原对糖尿病足感染患者 截趾风险的预测价值()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2015年06期
页码:
370-373
栏目:
论著
出版日期:
2015-11-20

文章信息/Info

Title:
Predictive value of serum procalcitonin in amputation risk of patients with diabetic foot infection
作者:
赵荣亚 王鹏华 张靖航 孙幸幸 侯小丽
300070 天津医科大学代谢病医院糖尿病足科,卫生部激素与发育重点实验室
Author(s):
Zhao Rongya;  Wang Penghua; Zhang Jinghang; Sun Xingxing; Hou Xiaoli.
Key Laboratory of Hormones and Development,Ministry of Health,Department of Diabetic Foot, The Metabolic Diseases Hospital of Tianjin Medical University, Tianjin 300070, China
关键词:
降钙素原;  糖尿病足;  感染;  截趾
Keywords:
Procalcitonin;  Diabetic foot;  Infection;  Amputation
DOI:
DOI:10.3760/cma.j.issn.1673-4157.2015.06.003
摘要:
目的 探讨糖尿病足感染(DFI)患者血清降钙素原(PCT)对截趾风险的预测价值。方法 选取118例DFI患者, 收集患者一般资料,并于入院当天及7 d后复查血清PCT、C反应蛋白(CRP)及白细胞计数,根据出院结局分为截趾组40例和非截趾组78例,比较两组一般资料和炎性反应指标的差异; 分析截趾的独立危险因素; 绘制受试者工作特征(ROC)曲线并计算曲线下面积来比较各炎性反应指标对于截趾风险的预测价值。结果 截趾组患者深部溃疡比例高[95.0%(38/40)vs.59.0%(46/78), χ2=16.730],合并骨髓炎[67.5%(27/40)vs. 14.4%(12/78), χ2=32.455]、高黏滞血症[80.0%(32/40)vs.33.3%(26/78),χ2=23.039]、肢体缺血[62.5%(25/40)vs.30.8%(24/78), χ2=10.964]及低蛋白血症[30.0%(12/40)vs.10.3%(8/78), χ2=7.322]较多且基线及治疗后PCT(t=7.531,t=6.856)、CRP(t=8.736,t=8.038)、白细胞计数(t=3.058,t=4.154)均高于非截趾组,差异具有统计学意义(P均﹤0.05)。多因素非条件Logistic回归显示:肢体缺血[优势比(OR)=8.228, 95%CI:1.624～41.694,P=0.011]、骨髓炎(OR=9.296, 95%CI:1.830～47.227,P=0.007)、基线PCT(OR=6.499, 95%CI:1.785～23.664,P=0.005)及CRP(OR=4.433, 95%CI:1.391～14.130,P=0.012)水平升高是截趾的独立危险因素; ROC曲线下基线PCT的面积高于CRP的面积(0.868 vs.0.846),基线PCT、CRP的最佳截断点分别为383.5 ng/L(敏感性85.0%、特异性76.9%)、10.85 mg/L(敏感性82.5%、特异性82.1%)。结论 血清高水平PCT、CRP对DFI患者的截趾均具有预测价值,且PCT优于CRP。
Abstract:
Objective To investigate the predictive value of procalcitonin(PCT)for the risk of amputation in patients with diabetic foot infection(DFI). Methods A total of 118 patients with DFI were enrolled in the study. The general informations of patients were collected, and serum PCT, C reaction protein(CRP)and white blood cell(WBC)count were tested in the day of admission and after 7 days. According to the outcome, patients were divided into amputation group(40 cases)and non-amputation group(78 cases).Differences of general informations and inflammatory indicators were compared among two groups.Independent risk factors for amputation were analyzed. Receiver operating characteristic(ROC)curve was generated and area under curve(AUC)was calculated to compare the predictability of serum inflammation indicators for amputation. Results Compared with non-amputation group, patients in amputation group had more deep ulcer [95.0%(38/40)vs.59.0%(46/78), χ2=16.730], osteomyelitis[67.5%(27/40)vs.14.4%(12/78),χ2=32.455],hyperviscosity[80.0%(32/40)vs.33.3%(26/78), χ2=23.039],limb ischemia[62.5%(25/40)vs.30.8%(24/78),χ2=10.964], hypoproteinemia[30.0%(12/40)vs.10.3%(8/78), χ2=7.322], high level of baseline and post-treatment PCT(t=7.531,t=6.856),CRP(t=8.736, t=8.038)and WBC count(t=3.058,t=4.154).Differences were statistically significant(all P<0.05). Multivariate Logistic regression analysis demonstratedthat limb ischemia [odd ratio(OR)=8.228, 95%CI:1.624-41.694,P=0.011], osteomyelitis(OR=9.296, 95%CI:1.830-47.227,P=0.007),baseline PCT(OR=6.499, 95%CI:1.785-23.664, P=0.005)and CRP(OR=4.433, 95%CI:1.391-14.130, P=0.012)were independent risk factors of amputation. Area under ROC curve of baseline PCT was higher than that of baseline CRP(0.868 vs. 0.846); the best cut-off value of baseline PCT and CRP were 383.5 ng/L(the sensitivity was 85.0% and the specificity was 76.9%)and 10.85 mg/L(the sensitivity was 82.5% and the specificity was 82.1%), respectively. Conclusion High level of serum PCT and CRP have predictive value for the risk of amputation in patients with diabetic foot infection, and PCT is superior than CRP.

参考文献/References:

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备注/Memo

备注/Memo:
作者单位:300070 天津医科大学代谢病医院糖尿病足科,卫生部激素与发育重点实验室 通信作者:王鹏华,Email:wph200000@163.com
更新日期/Last Update: 2015-11-20