血清C反应蛋白、前白蛋白及其比值在2型糖尿病足中医证型之间的表达水平及结局分析  

Expression Levels and Outcome Analysis of Serum C-reactive Protein,Proalbu⁃min,and Their Ratios in TCM Syndromes of Type 2 Diabetic Foot

作　　者：尚俊良 王广宇[1] 石春红 徐旭英[1] SHANG Jun-liang;WANG Guang-yu;SHI Chun-hong;XU Xu-ying(Department of Vascular Surgery,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010)

机构地区：[1]首都医科大学附属北京中医医院疮疡血管外科,北京100010

出　　处：《世界中西医结合杂志》2023年第9期1799-1804,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(面上项目)(82174388)。

摘　　要：目的探讨血清C反应蛋白(C-reactive protein,CRP)、前白蛋白(Prealbumin,PA)及其血清C反应蛋白与前白蛋白的比值(CRP/PA)在2型糖尿病足中医证型之间的表达水平及结局分析。方法回顾性分析2019年1月—2020年1月期间在首都医科大学附属北京中医医院疮疡血管外科行糖尿病足治疗的60例患者的临床资料。根据2型糖尿病足中医辨证分型分为三组:经络阻滞证组、湿毒蕴阻证组和阳虚血瘀证组;根据2型糖尿病足结局分为两组:清创组和截趾/肢/亡组。检测不同分组患者血清CRP、PA和CRP/PA水平,并分析CRP、PA及CRP/PA值与糖尿病足结局的相关性。结果2型糖尿病足中医辨证分型结果:经络阻滞证组10例(16.67%),湿毒蕴阻证组29例(48.33%),阳虚血瘀证组21例(35%);糖尿病足类型中缺血型22例,神经型16例,神经-缺血型22例;糖尿病足结局中清创23例,截趾/肢/亡37例。不同证型分组2型糖尿病足患者一般资料比较:湿毒蕴阻证组患者空腹血糖、钠、糖化血红蛋白与阳虚血瘀证组比较,差异有统计学意义(P<0.05);经络阻滞证组、湿毒蕴阻证组、阳虚血瘀证组三组患者年龄、糖尿病病程(年)、血红蛋白、白细胞计数(White blood cell,WBC)、白蛋白比较,差异无统计学意义(P>0.05)。血清CRP水平在2型糖尿病足中医辨证分型三组中的水平:湿毒蕴阻证组>阳虚血瘀证组>经络阻滞证组,三组两两比较差异具有统计学意义(P<0.05);血清PA水平在2型糖尿病足中医辨证分型三组中的水平:湿毒蕴阻证组<阳虚血瘀证组<经络阻滞证组,三组比较差异有统计学意义(P<0.05);血清CRP/PA水平在2型糖尿病足中医辨证分型三组中的水平:湿毒蕴阻证组>阳虚血瘀证组>经络阻滞证组,三组两两比较差异有统计学意义(P<0.05)。2型糖尿病足不同结局患者:截趾/肢/亡组血清CRP、CRP/PA水平明显高于清创组,差异有统计学意义(P<0.05);截趾/肢/亡组血清PA水平�Objective To explore the expression levels of serum C-reactive protein(CRP),prealbumin(PA),and the CRP/PA ratio in different traditional Chinese medicine(TCM)syndromes of type 2 diabetic foot and their associa⁃tion with clinical outcomes.Methods A retrospective analysis was conducted on the clinical data of 60 patients who re⁃ceived treatment for type 2 diabetic foot at the Department of Vascular Surgery,Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University between January 2019 and January 2020.Based on the TCM syndromes of type 2 diabetic foot,patients were categorized into three groups:meridian and collateral blockage syndrome,dampness-tox⁃in stagnation syndrome,and yang deficiency and blood stasis syndrome.According to the outcomes of type 2 diabetic foot,patients were divided into two groups:wound healing group and toe amputation/limb amputation/necrosis group.Serum CRP,PA,and CRP/PA levels were measured in different groups,and the correlations of CRP,PA,and CRP/PA values with type 2 diabetic foot outcomes were analyzed.Results In terms of TCM syndromes of type 2 diabetic foot,10 cases were diagnosed with meridian and collateral blockage syndrome(16.67%),29 cases with dampness-toxin stagnation syn⁃drome(48.33%),and 21 cases with yang deficiency and blood stasis syndrome(35%).In terms of the type distribution of type 2 diabetic foot,22 cases were of ischemic type,16 cases were of neuropathic type,and 22 cases were of neuro-ische⁃mic type.In terms of the outcomes of type 2 diabetic foot,23 cases were assigned to the wound healing group and 37 to the toe amputation/limb amputation/necrosis group.Comparison of baseline characteristics among different TCM syndrome groups revealed statistically significant differences in fasting blood glucose,sodium,and glycated hemoglobin between the dampness-toxin stagnation syndrome group and the yang deficiency and blood stasis syndrome group(P<0.05).No sta⁃tistically significant differences were observed in age,disease course of

关 键 词：2型糖尿病足 血清C反应蛋白 前白蛋白 血清C反应蛋白与前白蛋白的比值 中医证型 结局 

分 类 号：R587.2[医药卫生—内分泌]