血清胆红素、Cys-C、血脂在糖尿病足诊断中的临床意义  

Clinical Significance of Serum Bilirubin,Cys-C and Blood Lipid in the Diagnosis of Diabetes Foot

作　　者：陈洪才[1] 马静[2] 王莉 CHEN Hongcai;MA Jing;WANG Li(Department of Laboratory,Linyi Mental Health Center/Linyi Fourth People's Hospital,Linyi Shandong 276000,China;Department of Nursing,Linyi Mental Health Center/Linyi Fourth People's Hospital,Linyi Shandong 276000,China)

机构地区：[1]临沂市精神卫生中心/临沂市第四人民医院检验科,山东临沂276000 [2]临沂市精神卫生中心/临沂市第四人民医院护理部,山东临沂276000

出　　处：《中国卫生标准管理》2023年第15期74-78,共5页China Health Standard Management

摘　　要：目的探讨2型糖尿病(diabetes mellitus type 2,T2DM)患者血清胆红素、胱抑素C(cystatin c,Cys-C)、血脂指标在糖尿病足发展中的预测价值。方法选取2020年6月—2022年6月临沂市精神卫生中心收治的50例糖尿病足患者作为观察组,另选同期收治的50例T2DM患者作为对照组,同期50例健康体检者作为健康组。比较三组间空腹血糖(asting plasma glucose,FPG)、餐后2 h血糖(2 h postprandial plasma glucose,2 hPG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、胆红素、Cys-C、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)水平差异;并依据Wagner分级将糖尿病足患者分为低级别组、中级别组及高级别组,比较三组间胆红素、Cys-C、TC、TG、LDL-C及HDL-C水平差异;绘制ROC曲线分析胆红素、Cys-C、TC、TG、LDL-C、HDL-C及联合检测预测糖尿病足发生的临床价值。结果观察组FPG、2 hPG、HbA1c高于对照组、健康组,差异有统计学意义(P<0.05)。观察组胆红素水平低于对照组、健康组,Cys-C、TC、TG、LDL-C高于对照组、健康组,HDL-C低于对照组、健康组,差异有统计学意义(P<0.05)。50例糖尿病足患者依据Wagner分级可分为23例低级别、18例中级别、9例高级别;高级别组胆红素水平低于中级别组、低级别组,Cys-C、TC、TG、LDL-C高于中级别组、低级别组,HDL-C低于中级别组、低级别组,差异有统计学意义(P<0.05)。绘制ROC曲线分析显示,胆红素、Cys-C、TC、TG、LDL-C、HDL-C及联合预测糖尿病足发生的曲线下面积分别为0.816、0.747、0.710、0.697、0.650、0.764、0.963,联合检测价值最高。结论血清胆红素、Cys-C及血脂指标在糖尿病足诊断中具有一定价值,联合检测不仅能评估糖尿病足病情严重程度,还可提高糖尿病足的诊断价值。Objective To explore the predictive value of serum bilirubin,cystatin C(Cys-C)and blood lipid in the occurrence of diabetes foot in patients with type 2 diabetes(T2DM).Methods A total of 50 patients with diabetes foot admitted to Linyi Mental Health Center from June 2020 to June 2022 were selected as the observation group,another 50 patients with T2DM admitted at the same time were selected as the control group,and 50 healthy people were selected at the same time as the health group.Compare fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG),glycated hemoglobin(HbA1c),bilirubin,Cys-C,total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C)High-density lipoprotein cholesterol(HDL-C)level difference.According to Wagner classification,patients with diabetes foot were divided into low,middle group and high group grade group,and the levels of bilirubin,Cys-C,TC,TG,LDL-C and HDL-C were compared among the three groups;Draw ROC curve to analyze the clinical value of bilirubin,Cys-C,TC,TG,LDL-C,HDL-C and joint detection in predicting the occurrence of diabetes foot.Results FPG,2 hPG,and HbA1c levels in the observation group were higher than those in the control group and healthy group,with statistical significance(P<0.05).The bilirubin levels in the observation group were lower than those in the control group and the healthy group,while Cys-C,TC,TG,LDL-C were higher than that of control group and healthy group,and HDL-C was lower than that of control group and healthy group,with a statistically significant difference(P<0.05).A total of 50 patients with diabetes foot can be divided into 23 cases of low grade,18 cases of medium grade,and 9 cases of high grade according to Wagner grade;The bilirubin levels in the high-level group were lower than those in the intermediate and low-level groups,while Cys-C,TC,TG,LDL-C were higher than that of middle and low level groups,and HDL-C was lower than that of middle and low level groups,with statistically significant differences(P<0.05).The ROC

关 键 词：2型糖尿病 糖尿病足 血清胆红素 胱抑素C 血脂 诊断价值 

分 类 号：R587[医药卫生—内分泌]