氧化应激、炎症相关指标与糖尿病足溃疡的相关性研究

Study on correlation between oxidative stress,inflammatory factors and diabetic foot ulcers

目的:研究氧化应激、炎症相关指标与糖尿病足溃疡的相关性。方法:回顾性分析120例2型糖尿病患者的临床病历资料,根据是否并发糖尿病足分为单纯组、合并组,每组60例,另取60例同期健康体检者作为对照组。采用酶联免疫吸附试验(ELISA)检测血清超氧化物歧化酶(SOD)、血清淀粉酶A(SAA)、超敏C反应蛋白(hs-CRP)、抗钙素原(PCT)、D-二聚体、凝血因子Ⅷ水平及中性粒细胞计数,采用全自动生化分析仪检测血清糖化血红蛋白(HbA1c)水平,分析比较各组氧化应激、炎症相关指标水平的差异并进行相关性研究,采用Logistic回归分析研究糖尿病足溃疡的危险因素。结果:①合并组高血压患病率、冠心病患病率及血清HbA1c、hs-CRP、PCT水平高于对照组(P<0.001),血清D-二聚体、凝血因子Ⅷ、SAA水平及中性粒细胞计数高于对照组、单纯组,血清SOD水平低于对照组、单纯组(P<0.001)。②血清SOD水平与糖尿病足溃疡呈负相关,血清SAA水平与糖尿病足溃疡呈正相关(r=0.778,P<0.001;r=-0.603,P<0.001)。③Logistic回归分析结果显示,SAA、SOD水平是糖尿病足溃疡发生的独立危险因素。结论:糖尿病足溃疡患者机体氧化应激损伤严重,积极监测SOD、SAA水平有助于评估糖尿病足病变程度。

Objective:To study the correlation between oxidative stress,inflammation related indexes and diabetic foot ulcers.Methods:The clinical data of 120 patients with type 2 diabetes mellitus were retrospectively analyzed.According to whether complicated with diabetic foot,the patients were divided into the simple group and combined group,60 cases in each group.Another 60 healthy subjects in the same period were taken as the control group.The levels of serum superoxide dismutase(SOD),serum amylase A(SAA),high sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),D-dimer,coagulation factorⅧand neutrophil count were detected by enzyme-linked immunosorbent assay(ELISA),and the level of serum glycosylated hemoglobin(HbA1c)was detected by automatic biochemical analyzer.The differences of oxidative stress and inflammation related indexes in each group were analyzed and compared.The risk factors of diabetic foot ulcers were studied by Logistic regression analysis.Results:①The prevalence of hypertension and coronary heart disease and the serum levels of HbA1c,hs-CRP and PCT in the combined group were higher than those in the control group(P<0.001).The serum levels of D-dimer,coagulation factorⅧ,SAA and neutrophil count were higher than those in the control group and simple group,and the level of serum SOD was lower than those in the control group and simple group(P<0.001).②Serum SOD level was negatively correlated with diabetic foot ulcers,and serum SAA level was positively correlated with diabetic foot ulcers(r=0.778,P<0.001;r=-0.603,P<0.001).③Logistic regression analysis showed that SAA and SOD levels were independent risk factors for occurrence diabetic foot ulcers.Conclusion:Oxidative stress injury is serious in diabetic foot ulcers patients.Monitoring SOD and SAA levels is helpful to assess the degree of diabetic foot lesions.