糖尿病足感染的机制及血清降钙素原的监测价值  

The mechanism of diabetic foot infection and the monitoring value of serum procalcitonin

作　　者：何斯 郭玲悦 严晶 张翀[1] HE Si;GUO Lingyue;YAN Jing(Department of Clinical Laboratory,Gansu Provincial Maternal and Child Health Care Hospital,Gansu Provincial Central Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省妇幼保健院/甘肃省中心医院临床检验中心,兰州730000

出　　处：《医师在线》2025年第2期91-95,共5页Journal of Doctors Online

摘　　要：糖尿病足溃疡(DFU)是糖尿病最严重的并发症之一,患者可能面临下肢截肢,甚至死亡的风险。糖尿病患者高血糖和缺氧环境为病原微生物的增殖、毒力增强及生物膜形成提供了有利条件,而周围神经病变受损和外周血管疾病导致机体免疫功能降低和免疫细胞功能改变,使得糖尿病足感染(DFI)成为影响溃疡创面迁延不愈、反复发生的主要因素。目前,国内外关于DFI发生机制的研究相对不足,其发病机制复杂,主要涉及糖尿病患者免疫功能抑制,以及慢性炎症状态和高血糖、缺氧等微环境对病原微生物的影响。临床在诊断DFI时,主要依赖病原微生物培养和传统炎症标志物检测,降钙素原(PCT)因其较高的灵敏度和特异度,在诊断DFI及其并发症方面具有重要的作用。此外,PCT还可用于评估抗生素使用情况和不良预后、下肢截肢等风险。因此,了解PCT对DFI监测价值尤为重要。本文旨在探讨DFI的发病机制,并评估PCT在DFI诊断和预后监测中的能力。Diabetic foot ulcer(DFU)is one of the most serious complications of diabetes,and patients may face the risk of lower limb amputation and even death.The hyperglycemia and hypoxia environment in diabetic patients provide favorable conditions for the proliferation,virulence enhancement and biofilm formation of pathogenic microorganisms,while the impairment of peripheral neuropathy and peripheral vascular diseases lead to decreased immune function and the change of immune cell function,making diabetic foot infection(DFI)the main factor affecting the ulcer wound extension,non-healing and recurrence.At present,studies on the pathogenesis of DFI at home and abroad are relatively insufficient,and its pathogenesis is complex,mainly involving immune suppression in diabetic patients,and the influence of chronic inflammation,hyperglycemia,hypoxia and other microenvironments on pathogenic microorganisms.The clinical diagnosis of DFI mainly relies on the culture of pathogenic microorganisms and the detection of traditional inflammatory markers.Procalcitonin(PCT)plays an important role in the diagnosis of DFI and its complications due to its high sensitivity and specificity.In addition,PCT can be used to assess antibiotic use and the risk of poor prognosis,lower limb amputation,etc.Therefore,it is particularly important to fully grasp the value of PCT in DFI monitoring.The objective of this study was to investigate the pathogenesis of DFI and to evaluate the role of PCT in the diagnosis and prognostic monitoring of DFI.

关 键 词：糖尿病足溃疡 糖尿病足感染 降钙素原 

分 类 号：R587.2[医药卫生—内分泌]