外周血Th1/Th2细胞及其细胞因子对老年糖尿病足溃疡患者的预后价值  

Prognostic value of peripheral blood Th1/Th2 cells and their cytokines in elderly patients with diabetic foot ulcers

作　　者：李肖 王丽娟 李凯伦 雷达鑫 LI Xiao;WANG Lijuan;LI Kailun;LEI Daxin(Department of Clinical Laboratory,980th Hospital,PLA Joint Logistic Support Force,Shijiazhuang,Hebei 050000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院检验科,河北石家庄050000

出　　处：《国际检验医学杂志》2025年第1期86-90,共5页International Journal of Laboratory Medicine

基　　金：河北省重点研发计划项目(22103820029D)。

摘　　要：目的探讨外周血Th1/Th2细胞及其细胞因子对老年糖尿病足溃疡(DFU)患者的预后价值。方法选取2021年1月至2023年8月该院收治的136例老年DFU住院患者作为研究对象,根据按Wagner分级标准将其分为轻度组(0~2级,75例)和重度组(3~4级,61例)。所有患者均给予对症治疗,通过门诊定期复查、微信和电话等途径随访6个月,根据6个月预后分为预后良好组(95例)与预后不良组(41例)。比较两组基线资料、外周血Th1细胞及其细胞因子[白细胞白介素(IL)-2、干扰素γ(INF-γ)]、Th2细胞及其细胞因子(IL-4、IL-10),分析Th1/Th2细胞及其细胞因子与DFU严重程度的相关性及对预后的影响,评价Th1/Th2细胞及其细胞因子对DFU预后不良的预测效能。结果与预后良好组比较,预后不良组外周血Th1细胞、IL-2、INF-γ水平较高,Th2细胞、IL-4、IL-10水平较低,差异均有统计学意义(P<0.05);与轻度组者相比,重度组外周血Th1细胞、IL-2、INF-γ水平较高,Th2细胞、IL-4、IL-10水平较低,差异均有统计学意义(P<0.05);在校正体重指数(BMI)、DFU病程、糖尿病(DM)血管并发症、DFU严重程度后,Th1细胞、IL-2、INF-γ、Th2细胞、IL-4、IL-10均是DFU预后的独立影响因素(P<0.05);Th1细胞、IL-2、INF-γ、Th2细胞、IL-4、IL-10联合预测DFU预后不良的曲线下面积(AUC)大于各指标单独预测。结论外周血Th1/Th2细胞及其细胞因子与老年DFU患者病情程度密切相关,是预后不良的独立预测因子,各指标联合对老年DFU患者预后具有较好的预测价值。Objective To explore the prognostic value of peripheral blood Th1/Th2 cells and their cytokines in elderly patients with diabetic foot ulcer(DFU).Methods A total of 136 elderly DFU patients admitted to our hospital from January 2021 to August 2023 were selected as the study objects,and were divided into mild group(grade 0-2,75 cases)and severe group(grade 3-4,61 cases)according to Wagner grading criteria.All patients were given symptomatic treatment,and were followed up for 6 months by regular outpatient reexaminations,WeChat and telephone.According to the 6-month prognosis,they were divided into good prognosis group(95 cases)and poor prognosis group(41 cases).Baseline data,peripheral blood Th1 cells and their cytokines[interleukin(IL)-2,interferonγ(INF-γ)],Th2 cells and their cytokines(IL-4,IL-10)were compared between the two groups.The predictive efficacy of Th1/Th2 cells and their cytokines on poor prognosis of DFU was evaluated.Results Compared with the good prognosis group,the levels of Th1 cells,IL-2 and INF-γin peripheral blood of the poor prognosis group were higher,and the levels of Th2 cells,IL-4 and IL-10 were lower,with statistical significance(P<0.05).Compared with mild group,the levels of Th1 cells,IL-2 and INF-γin peripheral blood of severe group were higher,and the levels of Th2 cells,IL-4 and IL-10 were lower,with statistical significance(P<0.05).After adjusting for body mass index(BMI),duration of DFU,vascular complications of diabetes mellitus and severity of DFU,Th1 cells,IL-2,INF-γ,Th2 cells,IL-4 and IL-10 were the independent prognoses of DFU(P<0.05).The AUC of the combination of Th1 cells,IL-2,INF-γ,Th2 cells,IL-4 and IL-10 predicted the poor prognosis of DFU was greater than that predicted by each indicator alone.Conclusion Peripheral blood Th1/Th2 cells and their cytokines are closely related to the degree of disease in elderly DFU patients,and are independent predictors of poor prognosis.The combination of the indicators has a good predictive value for the prognosis of elderly DFU

关 键 词：糖尿病足溃疡 TH1细胞 TH2细胞 细胞因子 预后 

分 类 号：R587.2[医药卫生—内分泌] R446.1[医药卫生—内科学]