血管内表皮生长因子表达水平与糖尿病足老年患者溃疡感染及预后的关系  

Relationship between vascular endothelial growth factor expression and ulcer infection and the prognosis in elderly patients with diabetic foot

作　　者：乔彦 易诗琼 何明海 滕云 QIAO Yan;YI Shiqiong;HE Minghai;TENG Yun(Department of Endocrinology,Nanchong Central Hospital,Nanchong,Sichuan 637000 China)

机构地区：[1]南充市中心医院内分泌科,四川南充637000

出　　处：《热带医学杂志》2024年第12期1717-1721,共5页Journal of Tropical Medicine

基　　金：四川省自然科学基金项目(23NSFSC1952);南充市基础研究平台项目(23JCYJPT0028)。

摘　　要：目的探究血管内表皮生长因子(VEGF)表达水平与糖尿病足老年患者溃疡感染及预后的关系,以期为临床诊治糖尿病足溃疡(DFU)提供一定参考依据。方法选择2020年8月-2022年8月于南充市中心医院就诊的DFU感染患者112例,根据感染深度将其分为浅部感染组(n=59)和深部感染组(n=53),收集所有受试者的一般资料,记录其实验室指标、VEGF表达及免疫功能情况。根据预后情况将患者分为未愈合组(n=39)及愈合组(n=73),比较两组VEGF表达及免疫功能情况,并采用受试者工作特征(ROC)曲线分析VEGF表达对老年DFU感染患者预后评估价值。结果浅部感染组与深部感染组患者糖化血红蛋白(HbAlc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL⁃C)、高密度脂蛋白胆固醇(HDL⁃C)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平比较,差异均无统计学意义(P均>0.05);浅部感染组患者踝肱指数(ABI)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、血清VEGF、VEGF mRNA表达水平均高于深部感染组,差异均有统计学意义(t=18.118、21.396、16.029、12.063、5.237、15.863,P均<0.05)。血清VEGF、VEGF mRNA水平与DFU患者感染程度、CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均成负相关(r血清VEGF=-0.623、-0.541、-0.582、-0.674,rVEGF mRNA=-0.584、-0.539、-0.573、-0.625,P均<0.05)。愈合组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、血清VEGF、VEGF mRNA表达水平均高于未愈合组,差异均有统计学意义(t=22.947、24.018、18.889、4.229、16.901,P均<0.05)。ROC曲线分析显示,血清VEGF、VEGF mRNA诊断DFU感染预后的曲线下面积(AUC)分别为0.711、0.798。结论VEGF表达与老年DFU感染程度及免疫功能相关,对患者预后具有较高价值。Objective To explore the relationship between vascular endothelial growth factor(VEGF)expression and ulcer infection and the prognosis in elderly patients with diabetic foot,in order to provide some reference for clinical diagnosis and treatment of diabetic foot ulcers(DFU).Methods A total of 112 patients with DFU treated in the Nanchong Central Hospital were enrolled between August 2020 and August 2022.According to the severity of infection,they were divided into superficial infection group(n=59)and deep infection group(n=53).The general data of all the objects were collected,and laboratory indexes,VEGF expression and immune function were recorded.According to prognosis,patients were divided into non⁃healing group(n=39)and healing group(n=73);VEGF expression and immune function in the two groups were compared.The evaluation value of VEGF expression for the prognosis of elderly patients with DFU infection was analyzed by receiver operating characteristic(ROC)curves.Results There was no significant difference in the levels of hemoglobin A1c(HbAlc),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL⁃C),high density lipoprotein cholesterol(HDL⁃C),aspartate transaminase(AST)and alanine aminotransferase(ALT)between superficial infection group and deep infection group(all P>0.05).The levels of ankle brachial index(ABI),CD3^(+),CD4^(+),CD4^(+)/CD8^(+),serum VEGF and VEGF mRNA in superficial infection group were higher than those in deep infection group(t=18.118,21.396,16.029,12.063,5.237,15.863;all P<0.05).The levels of serum VEGF and VEGF mRNA were negatively correlated with infection severity,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)(r serum VEGF=-0.623,-0.541,-0.582,-0.674;r VEGF mRNA=-0.584,-0.539,-0.573,-0.625;all P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),serum VEGF and VEGF mRNA in healing group were higher than those in non⁃healing group(t=22.947,24.018,18.889,4.229,16.901;all P<0.05).ROC curves analysis showed that area under curve values of serum VEGF and VEGF mRNA for pr

关 键 词：血管内表皮生长因子 糖尿病足 溃疡 感染 免疫功能 

分 类 号：R587.2[医药卫生—内分泌]