超敏C反应蛋白、内皮抑素在糖尿病肢端坏疽早期病变中的诊断意义  

Significance of high-sensitivity C-reactive protein and endostatin in early diagnosis of diabetic gangrene

作　　者：胡银娥[1] 代淑芳[1] 刘扬[2] 

机构地区：[1]河南大学淮河医院皮肤科,河南开封475000 [2]河南大学淮河医院糖尿病科,河南开封475000

出　　处：《中国现代医学杂志》2016年第18期39-43,共5页China Journal of Modern Medicine

摘　　要：目的探讨超敏C反应蛋白(hs-CRP)、内皮抑素(ES)在糖尿病肢端坏疽早期病变(DG)中的诊断价值。方法将106例2型糖尿病患者,按照是否出现糖尿病足分为单纯糖尿病组(DM组)和糖尿病肢端坏疽早期病变组(DG组),采用超敏乳胶增强散射比浊法测定hs-CRP,ELISA法测定ES,检测其在DG中的诊断价值。结果 DG组自主神经病变(DAN)、下肢动脉管病变(LEAD)、微量尿蛋白(MAU)、踝肱指数(ABI)、低密度脂蛋白(LDL-C)、hs-CRP、血管内皮生长因子(VEGF)、ES以及欧米诺变色开始时间、完全变色时间均高于DM组(P<0.05或P<0.01);Spearman相关性分析发现,hs-CRP与DAN、LEAD、VEGF、ES、LDL-C呈正相关(r=0.486、0.477、0.505、0.503和0.473,P<0.05),与ABI呈负相关(r=-0.488,P<0.05);ES与DAN、LEAD、VEGF、hs-CRP呈负相关(r=-0.507,-0.501,-0.492和-0.508,P<0.05),与ABI呈负相关(r=0.497,P<0.05);ES+hs-CRP诊断在敏感性、特异性、阳性预测值、阴性预测值、诊断准确率及AUC均高于ES、hs-CRP单独诊断。结论 ES、hs-CRP与DG以及合并有自主神经病变具有明显相关性,ES联合hs-CRP对于DG具有较高的诊断价值。Objective To investigate the high-sensitivity C-reactive protein （hs-CRP） and endostatin （ES） in early diagnosis of diabetic limb gangrene （DG）. Methods A total of 106 T2DM patients were divided into simple diabetic group （DM） and early diabetic gangrene group （DG group）. hs-CRP was measured using ultra-sensitive latex-en-hanced scattering immunoturbidimetric assay. ES was determined by ELISA. Their value in diagnosis of DG was de-tected. Results DAN, LEAD, MAU, ABI, LDL-C, hs-CRP, VEGF and ES levels in the DG group were higher than those of the DM group （P〈0.05）. The Ou Mino discoloration started earlier and the complete discoloration time was longer in the DG group than in the DM group （P〈0.05）. Spearman correlation analysis showed that hs-CRP was positively correlated with DAN, LEAD, VEGF, ES and LDL-C （ = 0.486, 0.477, 0.505, 0.503 and 0.473, respec-tively; P〈 0.05）, but was in a negative correlation with ABI （ r= -0.488, P〈 0.05）; ES was negatively correlated with DAN, LEAD, VEGF and hs-CRP （r = -0.507, -0.501, -0.492 and -0.508; P〈 0.05）, but positively correlated with ABI （ r= 0.497, P〈 0.05）. The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and AUC of the combination of ES and hs-CRP were higher than those of ES and hs-CRP alone in diagnosis of DG. Conclusions ES and hs-CRP have significant correlations with DG and autonomic neuropathy.ES combined with hs-CRP has high diagnostic value for DG.

关 键 词：超敏C反应蛋白 内皮抑素 糖尿病肢端坏疽早期病变 诊断 

分 类 号：R587.1[医药卫生—内分泌]