糖尿病足患者骨代谢指标的特点及手术治疗效果分析  

作　　者：王俊[1] 何伟[1] 张杭 尤巧英[1] 

机构地区：[1]浙江省绍兴市人民医院,312000

出　　处：《浙江临床医学》2022年第9期1363-1366,共4页Zhejiang Clinical Medical Journal

摘　　要：目的探讨糖尿病足患者骨代谢指标的特点及手术治疗效果.方法选取2019年1月至2021年1月糖尿病足患者80例为观察组(DF组),糖尿病患者80例为对照组(NDF组),比较两组患者临床特征.观察糖尿病足患者接受手术或保守治疗骨代谢指标变化.结果与NDF组比较,DF组FPG、HOMA-IR、HbA1c、hsCRP、碱性磷酸酶、WBC、血小板、ESR、Fib均高于NDF组,而空腹胰岛素、空腹C肽、-CTX、PINP、25-(OH)D3水平、腰椎L_(2-4)、股骨颈处BMD低于NDF组(P<0.05);Pearson相关性分析显示,-CTX与PINP呈正相关(r=0.484,P<0.05);PINP与骨钙素呈正相关(r=0.242,P<0.05),与HbA1c、股骨颈、hsCRP、ESR呈负相关(r=-0.173、-0.237、-1.460、-1.440,P<0.05).手术治疗后骨钙素、-CTX、PINP、25-(OH)D3水平较术前升高(P<0.05);保守治疗组骨代谢指标随访与基线水平差异无统计学意义(P>0.05).结论DF患者-CTX、PINP水平降低,骨转换指标异常,存在更高的骨质疏松风险.相对于保守治疗,手术治疗后DF患者-CTX、PINP水平得到改善.Objective To explore the crrelation between diabeic foot patients and bone metabolism indexes-CTX and PINP,and to determine the infuence of surgical or conservative treatment.Methods Eighty patients with diabetic feet who were hospitalized in the Endocrinology Department of Shaoxing People's Hospital from January 2019 to January 2021 were selected as the observation group(DF group),and at the same time other 80 patients with diabetes were selected as the control group(NDF group).The clinical conditions of the two groups were compared.The changes of bone metabolism indexes in diabetic foot patients undergoing surgery or conservative treatment were observed.Results Compared with the NDF group,FPG,HOMA-IR,HbAlc,hsCRP,alk aline phosphatase,WBC,platelets,ESR,and Fib in the DF group were higher than those in the NDF group,while fasting insulin,fasting C-peptide,-CTX.PINP,25-(OH)D3 level,lumbar spine L_(2-4) and femoral neck BMD were lower than those in the NDF group(P<0.05).Pearson correlation analysis showed that-CTX was positively correlated with PINP(r=0.484,P<0.05).PINP and Ostcocalcin was positively crrelated(r=0.242.P<0.005),and negatively crrelated with HbAlc,femoral neck,hsCRP,and ESR(r=-0.173.-0.237.-1.460.-1.440.P<0.05).The levels of osteocalcin,-CTX,PINP,and 25-(OH)D3 after surgery were higher than those before surgery(P<0.05).There was no signifcant difference in fllowm up of bone metabolism indexes in the conservative treatment group compared with the baseline level(P>0.05).Conclusion DF patients have reduced levels of-CTX and PINP,abnormal bone turnover indicators.They mav have a higher risk of osteoporosis.Compared with conservative tretment,the leves of-CTX and PINP in DF patients improve after surgery.

关 键 词：糖尿病足 I型胶原羧基端肽β特殊序列 I型胶原氨基端前肽 25-羟维生素D3 骨代谢 

分 类 号：R587.2[医药卫生—内分泌]