糖尿病足溃疡合并感染患者TLR9、HSP70及胱抑素C水平及其对预后的预测价值  

TLR9,HSP70 and cystatin C of diabetic foot ulcer patients complicated wit infection and their values in prediction of prognosis

作　　者：胡飞雨 桑秀芳 吴帅 陈旭梅 陈红玉 HU Feiyu;SANG Xiufang;WU Shuai;CHEN Xumei;CHEN Hongyu(Hangzhou Geriatric Hospital,Hangzhou,Zhejiang 310022,China)

机构地区：[1]杭州市老年病医院创面修复科,浙江杭州310022

出　　处：《中华医院感染学杂志》2025年第4期555-559,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2020KY213)。

摘　　要：目的分析糖尿病足溃疡(DFU)合并感染患者外周血Toll样受体9(TLR9)、热休克蛋白70(HSP70)及胱抑素C(CysC)水平,并分析各指标对预后的预测价值。方法选取2021年1月-2024年1月杭州市老年病医院收治的96例DFU患者,根据感染情况分为感染组(n=66)和未感染组(n=30),并将感染患者根据感染程度分为轻、中、重度感染组,分别为27例、21例,18例,比较四组患者治疗前外周血TLR9、HSP70及CysC水平,Spearman相关性分析指标水平与感染程度的相关性;并根据感染组治疗效果分为有效组和无效组,比较两组间指标水平差异,采用受试者工作特征(ROC)曲线评估各指标预测患者预后的价值。结果感染组患者TLR9、HSP70、CysC水平分别为(4.47±1.23)、(29.01±7.42)ng/ml、(2.72±0.58)mg/L均高于未感染组,且均重度感染组>中度感染组>轻度感染组(均P<0.05)。经Spearman相关性分析显示,外周血TLR9、HSP70及CysC水平均与DFU感染程度呈正相关(r=0.537,0.626,0.639,均P<0.001)。经治疗后,所有感染组患者均完成2个月随访,其中痊愈和有效者共53例,纳入有效组,13例无效者纳入无效组;无效组TLR9、HSP70、CysC水平分别为(5.52±1.03)、(37.51±8.06)ng/ml、(3.13±0.84)mg/L均高于有效组(P<0.05)。TLR9、HSP70、CysC水平评估DFU合并感染患者曲线下面积分别为0.863、0.814、0.901。结论DFU合并感染患者血清TLR9、HSP70、CysC水平高表达,与感染程度和预后相关,且对感染预后具有较高预测价值。OBJECTIVE To analyze levels of peripheral blood Toll-like receptor 9(TLR9),heat shock protein 70(HSP7),and cystatin C(CysC),and their prognostic value in patients with diabetic foot ulcer(DFU)and infec-tion.METHODS A total of 96 patients with DFU admitted to Hangzhou Geriatric Hospital were enrolled between Jan.2021 and Jan.2024.According to presence or absence of infection,they were divided into an infection group(n=66)and a non-infection group(n=30).Based on the severity of infection,patients in infection group were further divided into a mild infection group(27 cases),a moderate infection group(21 cases)and a severe infection group(18 cases).The levels of peripheral blood TLR9,HSP70,and CysC in the four groups were compared be-fore treatment.The correlation between the three indexes and infection severity was analyzed by Spearman correla-tion analysis.According to curative effect,patients in infection group were divided into effective group and ineffec-tive group,and differences in TLR9,HSP70 and CysC between the two groups were compared.The predictive value of TLR9,HSP70 and CysC for prognosis was evaluated by receiver operating characteristic(ROC)curves.RESULTS The levels of TLR9,HSP70,and CysC in the infection group were(4.47±1.23),(29.01±7.42)ng/ml and(2.72±0.58)mg/L,higher than those in the non-infection group,and these were gradually decreased in the severe infection group,moderate infection group,and mild infection group(all P<o.05).Spearman correlation a-nalysis showed that levels of peripheral blood TLR9,HSP70,and Cys C were positively corelated with the sever-ity of DFU infection(r=0.537,0.626,0.639,all P<0.001).After treatment,all patients were followed up for 2 months in the infection group.Among them,there were 53 cases in the effective group(cured,effective treatment)and 13 cases in the ineffective group(ineffective treatment).The levels of TLR9,HSP70 and CysC in ineffective group were(5.52±1.03),(37.51±8.06)ng/ml and(3.13±0.84)mg/L,higher than thosein effectivegroup(P<0.05).The area under

关 键 词：糖尿病足溃疡 感染 早期评估 TOLL样受体9 热休克蛋白70 胱抑素C 预后 预测价值 

分 类 号：R781.64[医药卫生—口腔医学]