血清CD64、TNF⁃α评估糖尿病足感染患者病情严重程度及预后的价值  

Evaluation value of serum CD64 and TNF⁃αlevels for disease severity and prognosis in patients with diabetic foot infection

作　　者：姜向南 刘鹏程[1] 于文君[1] 汪波[2] 孟杰 JAING Xiangnan;LIU Pengcheng;YU Wenjun;WANG Bo;MENG Jie(Hand and Foot Surgery,Lequn Hospital,the First Hospital of Jilin University,Changchun,Jilin,China,130000;Department of Nephrology,Lequn Hospital,the First Hospital of Jilin University,Changchun,Jilin,China,130000)

机构地区：[1]吉林大学第一医院乐群院区手足外科,吉林长春130000 [2]吉林大学第一医院乐群院区肾病内科,吉林长春130000

出　　处：《分子诊断与治疗杂志》2025年第1期67-70,共4页Journal of Molecular Diagnostics and Therapy

基　　金：吉林省科技发展基金资助项目(20220414062GH)。

摘　　要：目的探讨血清CD64、肿瘤坏死因子⁃α(TNF⁃α)评估糖尿病足感染患者病情严重程度及预后的价值。方法选取2022年1月至2022年12月于吉林大学第一医院乐群院就诊的104例糖尿病足感染患者,按照糖尿病足wagner分级将患者按照病情严重程度分为轻度组(n=40)、中度组(n=46)、重度组(n=18),比较不同病情严重程度患者的血清CD64、TNF⁃α、降钙素原(PCT)、C反应蛋白(CRP)、白介素⁃6(IL⁃6)水平。采用Spearman分析糖尿病足病情严重程度与血清CD64、TNF⁃α、PCT、CRP、IL⁃6的相关性。将104例糖尿病足感染患者按照预后分为预后良好组(n=83)与预后不良组(n=21),比较不同预后患者的血清CD64、TNF⁃α、PCT、CRP、IL⁃6水平,采用受试者工作特征(ROC)曲线分析各指标及其联合检测对糖尿病足患者预后的评估价值。结果轻度组血清CD64、TNF⁃α、PCT、CRP水平低于中度组、重度组,差异有统计学意义(P<0.05)。Spearman分析结果显示,糖尿病足患者wagner分级与血清CD64、TNF⁃α、PCT、CRP、IL⁃6水平均为正相关(P<0.05)。预后良好组患者血清CD64、TNF⁃α、PCT、CRP、IL⁃6水平低于预后不良组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,血清CD64、TNF⁃α、PCT、CRP、IL⁃6及其联合评估糖尿病足患者预后的曲线下面积分别为0.835、0.754、0.737、0.697、0.692、0.924,各指标联合检测预测效能最高(P<0.05)。结论血清CD64、TNF⁃α水平与糖尿病足病情严重程度显著相关,对预后评估价值高于常规指标。临床医师可综合血清学指标评估,采取早期综合治疗。Objective To explore the evaluation value of serum CD64 and tumor necrosis factor⁃α(TNF⁃α)for disease severity and prognosis in patients with diabetic foot infection.Methods A total of 104 pa⁃tients with diabetic foot infection who were treated at Lequn Branch of the First Hospital of Jilin University were enrolled between January and December 2022.According to the Wagner grading of diabetic foot,patients were divided into the mild group(n=40),the moderate group(n=46),and the severe group(n=18).The levels of serum CD64,TNF⁃α,procalcitonin(PCT),C⁃reactive protein(CRP),and interleukin⁃6(IL⁃6)in the three groups were compared.The correlation between the severity of diabetic foot and the above serum indicators was analyzed using Spearman.Based on prognosis,all patients were divided into a good prognosis group(n=83)and a poor prognosis group(n=21).The levels of serum CD64,TNF⁃α,PCT,CRP,and IL⁃6 in the two groups were compared.The evaluation value of different serum indicators and combined detection for prognosis was analyzed using receiver operating characteristic(ROC)curves.Results The levels of serum CD64,TNF⁃α,PCT,and CRP gradually increased in the mild group,moderate group and severe group(P<0.05).The results of Spearman analysis showed that the Wagner grading of diabetic foot was positively correlated with the levels of serum CD64,TNF⁃α,PCT,CRP,and IL⁃6(P<0.05).The levels of serum CD64,TNF⁃α,PCT,CRP,and IL⁃6 in the good prognosis group were lower than those in the poor prognosis group(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)values of serum CD64,TNF⁃α,PCT,CRP,IL⁃6,and combined detection for evaluating the prognosis of patients with diabetic foot were 0.835,0.754,0.737,0.697,0.692,and 0.924(P<0.05),with the predictive efficiency of combined detection being the highest.Conclusion The levels of serum CD64 and TNF⁃αare significantly correlated with the severity of diabetic foot.The evaluation value of these two indicators is greater

关 键 词：糖尿病足感染 血清CD64 肿瘤坏死因子⁃α 

分 类 号：R587.2[医药卫生—内分泌]