糖尿病足感染下肢血管病变患者血清FGF-23和sLOx-1表达及其诊断价值  

Expressions of serum FGF-23 and sLOx-1 in diabetic foot infection patients complicated with peripheral arterial disease and their diagnostic values

作　　者：袁晨东 楼新江 赵灿松 何铁飞 周超军 YUAN Chen-dong;LOU Xin-jiang;ZHAO Can-song;HE Tie-fei;ZHOU Chao-jun(Zhuji People's Hospital of Zhejiang Province,Zhuji,Zhejiang 311800,China)

机构地区：[1]浙江省诸暨市人民医院血管外科,浙江诸暨311800

出　　处：《中华医院感染学杂志》2023年第18期2760-2763,共4页Chinese Journal of Nosocomiology

基　　金：浙江省中医药科学研究基金项目(2021ZA139)。

摘　　要：目的分析糖尿病足感染(DFI)下肢血管病变(PAD)患者血清成纤维细胞生长因子(FGF)-23、可溶性凝集素样氧化低密度脂蛋白受体(sLOx)-1表达及其诊断价值.方法选择2020年1月-2022年7月浙江省诸暨市人民医院血管外科诊治的162例DFI患者为研究对象,根据患者是否合并PAD分为PAD组和非PAD组;观察DFI感染病原学特点,分析血清FGF-23、sLOx-1水平及其诊断价值.结果162例DFI患者共检出158株病原菌,其中PAD组97株,非PAD组61株,PAD组患者检出革兰阴性菌占比及深部感染患者占比均高于非PAD组(P<0.05);PAD组患者血清FGF-23、sLOx-1水平均高于非PAD组(P<0.05);受试者工作特征(ROC)曲线分析结果显示,血清FGF-23、sLOx-1联合检测诊断DFI患者合并PAD的曲线下面积(AUC)为0.894;随着PAD分级的升高,血清FGF-23、sLOx-1水平逐渐升高(P<0.05),Spearman相关性分析显示,PAD严重程度与血清FGF-23、sLOx-1水平呈正相关(r=0.640,0.583,均P<0.001).结论DFI合并PAD患者检出的病原菌以革兰阴性菌为主,PAD严重程度与血清FGF-23、sLOx-1水平呈正相关,两者联合检测可辅助判断DFI患者是否合并PAD.OBJECTIVE To observe the expression of serum fibroblast growth factor(FGF)-23 and soluble lectinlike oxidized low density lipoprotein receptor 1(sLOx)-1 in diabetic foot infection(DFI)patients complicated with peripheral arterial disease(PAD)and analyze the diagnostic values.METHODS A total of 162 patients with DFI who were treated in vascular surgery department of Zhuji People's Hospital of Zhejiang Province from Jan 2020 to Jul 2022 were recruited as the research subjects and were divided into the PAD group and the non-PAD according to the status of complication with PAD.The etiological characteristics of DFI infection were observed,and the diagnostic values of serum FGF-23 and sLOx-1 were analyzed.RESULTS Totally 158 strains of pathogens were isolated from the 162 patients with DFI,97 of which were isolated from the PAD group,and 61 were isolated from the non-PAD group.The proportion of the gram-negative bacteria and the proportion of patients with deep infection were higher in the PAD group than in the non-PAD group(P<0.05).The levels of serum FGF-23 and sLOx-1 of the PAD group were higher than those of the non-PAD group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under curve(AUC)of the joint detection of serum FGF-23 and sL-Ox-1 was 0.894 in diagnosis of PAD in the DFI patients;the levels of serum FGF-23 and sLOx-1 were elevated with the rise of grade of PAD(P<0.05).Spearman correlation analysis indicated that the severity of PAD was positively correlated with the levels of serum FGF-23 and sLOx-1(r=0.640,0.583,all P<0.001).CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the DFI patients complicated with PAD.The severity of PAD is positively correlated with the levels of serum FGF-23 and sLOx-1,and the joint detection of the two indexes may help to determine whether the DFI patients are complicated with PAD.

关 键 词：糖尿病足感染 下肢血管病变 成纤维细胞生长因子-23 可溶性凝集素样氧化低密度脂蛋白受体-1 

分 类 号：R587.1[医药卫生—内分泌]