国际内分泌代谢杂志
國際內分泌代謝雜誌
국제내분비대사잡지
International Journal of Endocrinology and Metabolism
2015年
6期
370-373
,共4页
赵荣亚%王鹏华%张靖航%孙幸幸%侯小丽
趙榮亞%王鵬華%張靖航%孫倖倖%侯小麗
조영아%왕붕화%장정항%손행행%후소려
降钙素原%糖尿病足%感染%截趾
降鈣素原%糖尿病足%感染%截趾
강개소원%당뇨병족%감염%절지
Procalcitonin%Diabetic foot%Infection%Amputation
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7d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),x2=16.730],合并骨髓炎[67.5％(27/40)vs.14.4％(12/78),x2=32.455]、高黏滞血症[80.0％ (32/40)vs.33.3％ (26/78),x2=23.039]、肢体缺血[62.5％ (25/40)vs.30.8％ (24/78),x2=10.964]及低蛋白血症[30.0％(12/40)vs.10.3％(8/78),x2=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(0.868vs.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.
目的 探討糖尿病足感染(DFI)患者血清降鈣素原(PCT)對截趾風險的預測價值.方法 選取118例DFI患者,收集患者一般資料,併于入院噹天及7d後複查血清PCT、C反應蛋白(CRP)及白細胞計數,根據齣院結跼分為截趾組40例和非截趾組78例,比較兩組一般資料和炎性反應指標的差異;分析截趾的獨立危險因素;繪製受試者工作特徵(ROC)麯線併計算麯線下麵積來比較各炎性反應指標對于截趾風險的預測價值.結果截趾組患者深部潰瘍比例高[95.0％ (38/40)vs.59.0％(46/78),x2=16.730],閤併骨髓炎[67.5％(27/40)vs.14.4％(12/78),x2=32.455]、高黏滯血癥[80.0％ (32/40)vs.33.3％ (26/78),x2=23.039]、肢體缺血[62.5％ (25/40)vs.30.8％ (24/78),x2=10.964]及低蛋白血癥[30.0％(12/40)vs.10.3％(8/78),x2=7.322]較多且基線及治療後PCT(t=7.531,t=6.856)、CRP(t=8.736,t =8.038)、白細胞計數(t=3.058,t=4.154)均高于非截趾組,差異具有統計學意義(P均＜ 0.05).多因素非條件Logistic迴歸顯示:肢體缺血[優勢比(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)、基線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)水平升高是截趾的獨立危險因素;ROC麯線下基線PCT的麵積高于CRP的麵積(0.868vs.0.846),基線PCT、CRP的最佳截斷點分彆為383.5 ng/L(敏感性85.0％、特異性76.9％)、10.85 mg/L(敏感性82.5％、特異性82.1％).結論血清高水平PCT、CRP對DFI患者的截趾均具有預測價值,且PCT優于CRP.
목적 탐토당뇨병족감염(DFI)환자혈청강개소원(PCT)대절지풍험적예측개치.방법 선취118례DFI환자,수집환자일반자료,병우입원당천급7d후복사혈청PCT、C반응단백(CRP)급백세포계수,근거출원결국분위절지조40례화비절지조78례,비교량조일반자료화염성반응지표적차이;분석절지적독립위험인소;회제수시자공작특정(ROC)곡선병계산곡선하면적래비교각염성반응지표대우절지풍험적예측개치.결과절지조환자심부궤양비례고[95.0％ (38/40)vs.59.0％(46/78),x2=16.730],합병골수염[67.5％(27/40)vs.14.4％(12/78),x2=32.455]、고점체혈증[80.0％ (32/40)vs.33.3％ (26/78),x2=23.039]、지체결혈[62.5％ (25/40)vs.30.8％ (24/78),x2=10.964]급저단백혈증[30.0％(12/40)vs.10.3％(8/78),x2=7.322]교다차기선급치료후PCT(t=7.531,t=6.856)、CRP(t=8.736,t =8.038)、백세포계수(t=3.058,t=4.154)균고우비절지조,차이구유통계학의의(P균＜ 0.05).다인소비조건Logistic회귀현시:지체결혈[우세비(OR)=8.228,95％CI:1.624～41.694,P=0.011]、골수염(OR=9.296,95％CI:1.830～ 47.227,P=0.007)、기선PCT(OR=6.499,95％CI:1.785～ 23.664,P=0.005)급CRP(OR=4.433,95％ CI:1.391 ～14.130,P=0.012)수평승고시절지적독립위험인소;ROC곡선하기선PCT적면적고우CRP적면적(0.868vs.0.846),기선PCT、CRP적최가절단점분별위383.5 ng/L(민감성85.0％、특이성76.9％)、10.85 mg/L(민감성82.5％、특이성82.1％).결론혈청고수평PCT、CRP대DFI환자적절지균구유예측개치,차PCT우우CRP.
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), x2 =16.730], osteomyelitis [67.5％ (27/40) vs.14.4％ (12/78) ,x2 =32.455], hyperviscosity [80.0％ (32/40) vs.33.3 ％ (26/78), x2 =23.039], limb ischemia [62.5％ (25/40) vs.30.8％ (24/78) ,x2 =10.964], hypoproteinemia [30.0％ (12/40) vs.10.3％ (8/78), x2 =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 demonstrated that 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.
