同型半胱氨酸、红细胞体积分布宽度、糖化血红蛋白变异指数对糖尿病足发生的影响及预测价值  

Influence and predictive value of homocysteine,red cell volume distribution width,and glycosylated hemoglobin variation index on the occurrence of diabetic foot

作　　者：张琳[1] 龙俊宏[1] 黄丽丽[1] 田静宇 高菲 李友芳[2] ZHANG Lin;LONG Junhong;HUANG Lili;TIAN Jingyu;GAO Fei;LI Youfang(Department of Endocrinology,the Second Affiliated Hospital of Xi’an Jiaotong University,Shaanxi Province,Xi’an710004,China;Department of Urology Surgery,the Second Affiliated Hospital of Xi’an Jiaotong University,Shaanxi Province,Xi’an710004,China)

机构地区：[1]西安交通大学第二附属医院内分泌科,陕西西安710004 [2]西安交通大学第二附属医院泌尿外科,陕西西安710004

出　　处：《中国医药导报》2023年第15期73-76,共4页China Medical Herald

基　　金：陕西省重点研发计划项目(2022SF-140)。

摘　　要：目的探讨同型半胱氨酸(Hcy)、红细胞体积分布宽度(RDW)、糖化血红蛋白变异指数(HGI)对糖尿病足(DF)发生的影响及预测价值。方法选取2018年6月至2020年6月于西安交通大学第二附属医院内分泌科就诊的2型糖尿病(T2DM)患者166例,按照是否合并DF将其分为T2DM组(104例)及DF组(62例)。收集两组临床相关资料及Hcy、RDW水平,并计算HGI。采用二元logistic回归模型分析DF发生的影响因素,绘制受试者操作特征(ROC)曲线并计算曲线下面积(AUC),分析DF的预测指标及其预测价值。结果DF组年龄、糖化血红蛋白、空腹血糖(FBG)、Hcy、RDW、HGI均高于T2DM组,差异有统计学意义(P<0.05)。多因素分析结果显示,FBG、Hcy、RDW、HGI均为DF发生的独立影响因素(P<0.05)。ROC曲线分析结果显示,FBG、Hcy、RDW、HGI单独及联合对DF均有一定的预测价值,各指标联合预测的AUC高于单独预测(P<0.05)。结论FBG、Hcy、RDW、HGI联合预测可作为一种有效的T2DM患者DF治疗及护理介入时机的预测指标。Objective To explore the influence and predictive value of homocysteine(Hcy),red blood cell volume distribution width(RDW),and glycosylated hemoglobin variation index(HGI)on the occurrence of diabetes foot(DF).Methods A total of 166 patients with type 2 diabetes mellitus(T2DM)admitted to the Department of Endocrinology,the Second Affiliated Hospital of Xi’an Jiaotong University from June 2018 to June 2020 were selected and divided into T2DM group(104 cases)and DF group(62 cases)according to whether they had DF or not.Clinical data,Hcy,and RDW levels of the two groups were collected,and HGI was calculated.The influencing factors of DF occurrence were analyzed by binary logistic regression model,receiver operating characteristic(ROC)curve was drawn and area under the curve(AUC)was calculated,and the predictive index and their value of DF were analyzed.Results Age,glycosylated hemoglobin,fasting blood glucose(FBG),Hcy,RDW,and HGI in DF group were higher than those in T2DM group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that FBG,Hcy,RDW,and HGI were independent influencing factors of DF occurrence(P<0.05).The ROC curve analysis results showed that FBG,Hcy,RDW,and HGI had certain predictive value for DF alone and in combination,the AUC of combination of each index was higher than that of each single prediction(P<0.05).Conclusion The combined prediction of FBG,Hcy,RDW,and HGI can be an effective predictor of DF treatment and nursing intervention in T2DM patients.

关 键 词：2型糖尿病 糖尿病足 同型半胱氨酸 红细胞体积分布宽度 糖化血红蛋白变异指数 

分 类 号：R587.2[医药卫生—内分泌]